Biden administration chooses first 10 drugs for Medicare price negotiations

By: - August 29, 2023 11:41 am

Medicare enrollees will begin to see lower prices in 2026. (Getty Images)

WASHINGTON — Medicare can now negotiate lower prices for 10 common high-price drugs, cutting out-of-pocket costs for an estimated 9 million seniors and saving taxpayers billions, the Biden administration said Tuesday.

Medicare will begin this year to negotiate with the manufacturers of popular medications used to treat blood clots, diabetes, heart disease, rheumatoid arthritis, chronic kidney disease, psoriasis, blood cancers, Crohn’s disease and ulcerative colitis.

Enrollees will begin to see lower prices in 2026.

The prescription drug negotiations are a result of last year’s Inflation Reduction Act, a massive spending package that contained measures to reduce prescription drug prices, subsidize climate change reduction technology and adjust the corporate tax rate.

“For far too long, Americans have paid more for prescription drugs than any major economy. And while the pharmaceutical industry makes record profits, millions of Americans are forced to choose between paying for medications they need to live or paying for food, rent, and other basic necessities. Those days are ending,” President Joe Biden said in a statement Tuesday.

About 9 million enrollees in Medicare’s Part D prescription drug coverage program spent $3.4 billion out of pocket in 2022 on the 10 drugs selected for negotiation, according to a report released Tuesday by the U.S. Department of Health and Human Services.

The 10 drugs are: Eliquis, Enbrel, Entresto, Farxiga, Imbruvica, Januvia, Jardiance, multiple Fiasp and NovoLog insulin products, Stelara and Xarelto.

Democrats hailed the announcement of the selected drugs. The party held majorities in both the House and Senate when Congress passed the Inflation Reduction Act along party lines in August 2022.

“As I’ve traveled across Nevada, I’ve met seniors who shared their stories about not being able to afford their medications and being forced to make tough decisions as a result,” said U.S. Sen. Jacky Rosen, touting her vote to pass the legislation allowing Medicare to negotiate drug prices.

Shelbie Swartz, interim executive director of Battle Born Progress, called Tuesday’s announcement a “major milestone,” but added selecting the drugs “is just the first step. Now, CMS will have to move forward aggressively to negotiate with the drug corporations in order to arrive at fair prices that patients can afford. Rather than fight the new law with frivolous lawsuits, the drug corporations should cooperate.”

Of the nearly 66 million Americans enrolled in Medicare, 52 million are enrolled in the Part D prescription drug coverage plan, according to the Centers for Medicare and Medicaid Services enrollment dashboard.

The Inflation Reduction Act also made common adult vaccines, including shingles and TDAP, free for certain Medicare enrollees. Monthly insulin costs for Medicare enrollees were also reduced to $35 for Part D beneficiaries as part of the IRA, and beginning in 2025 annual out-of-pocket prescription drug costs will be capped at $2,000.

The law’s prescription drug provisions, including the government’s new ability to negotiate what it pays for certain drugs, is expected to reduce the federal deficit by $129 billion by 2031, according to a Congressional Budget Office analysis.

The government will choose 15 additional Part D-covered drugs in 2025 to negotiate lower prices beginning in 2027. Several more Part D and Part B drugs will be phased in for negotiations through 2029.

Camalot Todd contributed to this report.

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Ashley Murray
Ashley Murray

Ashley Murray covers the nation’s capital as a senior reporter for States Newsroom. Her coverage areas include domestic policy and appropriations.