Here are the top 10 negotiated Medicare drug prices

VaselineAugust 19, 2024

0 4 minutes read

Here are the top 10 negotiated Medicare drug prices

After many months of closely watched negotiations, the Centers for Medicare & Medicaid Services (CMS) announced the list of negotiated prices for 10 drugs. It marks the first set of negotiations between Medicare and drugmakers taking place as part of the Inflation Relief Act, which President Joe Biden signed into law in 2022.

“Americans pay too much for prescription drugs. That makes today’s announcement historic,” said Department of Health and Human Services (HHS) Secretary Xavier Becerra in a CMS news release.

The prices for the 10 drugs for which Medicare negotiated include the blockbusters Jardiance, Stelara and Eliquis. The drugs treat diabetes, heart failure, arthritis and more, and the negotiated prices are up to 79% lower than their prices in 2023. The negotiated prices apply to people with Medicare Part D drug coverage.

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The Biden White House said the negotiated prices will save taxpayers about $6 billion, and Medicare enrollees with Part D prescription drug coverage are expected to save $1.5 billion in out-of-pocket costs . The Congressional Budget Office estimates that Medicare will save $100 billion over the next 10 years as a result of these negotiations.

Medicare negotiated drug price list

Medicare announced the 10 drugs it chose to negotiate prices for last year. Those drugs were Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp/NovoLog.

CMS follows a specific set of parameters to determine which drugs are eligible for negotiations, which includes when the drugs were approved by the FDA and what they treat. After narrowing down a list of drugs eligible for negotiation based on the parameters, Medicare further narrowed the list down to these 10 drugs that had the highest Medicare Part D spending.

These are the negotiated prices, noting that each price is for a 30-day supply:

Eliquis:

Description of the drug: Eliquis is an anticoagulant used to treat and prevent blood clots. It is commonly prescribed to people who have atrial fibrillation, deep vein thrombosis, and pulmonary embolism, and to people who have recently had hip or knee replacement surgery and are therefore at greater risk of blood clots.
Negotiated price: $231
Price in 2023: $521
Price reduction: 56%

Jardiance

Description of the drug: Jardiance is usually prescribed to people with type 2 diabetes, heart failure, and chronic kidney disease. It used to reduce the risk of cardiovascular death for these patients; reduces the worsening of kidney disease; and lowering blood sugar for type 2 diabetics along with diet and exercise
Negotiated price: $197
Price in 2023: $573
Price reduction: 66%

Xarelto

Description of the drug: Xarelto is also, like Eliquis, used to prevent and treat blood clots, as well as to reduce the risk of serious heart problems, along with low-dose aspirin.
Negotiated price: $197
Price in 2023: $517
Price reduction: 62%

Januvia

Description of the drug: Januvia is prescribed to people with type 2 diabetes to help lower blood sugar levels, along with diet and exercise.
Negotiated price: $113
Price in 2023: $527
Price reduction: 79% – this is the largest price reduction of these negotiations in percentage terms

Farxiga

Description of the drug: Farxiga, like Jardiance, is prescribed to patients with type 2 diabetes, heart failure and chronic kidney disease.
Negotiated price: $178.50
Price in 2023: $556
Price reduction: 68%

Entresto

Description of the drug: Entresto is prescribed for people with long-standing or chronic heart failure
Negotiated price: $295
Price in 2023: $628
Price reduction: 53%

Enbrel

Description of the drug: Enbrel is prescribed to treat arthritis, psoriasis, and psoriatic arthritis. It should reduce joint pain and stop permanent joint damage
Negotiated price: $2,355
Price in 2023: $7,106
Price reduction: 67%

Imbruvica

Description of the drug: Imbruvica is used to treat blood cancers, including chronic lymphocytic leukemia, Waldenström’s macroglobulinemia, and chronic graft-versus-host disease (cGVHD). It is not a chemotherapy drug
Negotiated price: $9,319
Price in 2023: $14,934
Price reduction: 38%

Stargate

Description of the drug: Stelara is prescribed for people with Crohn’s disease, ulcerative colitis, plaque psoriasis and psoriatic arthritis. It is used through an IV infusion followed by a series of injections over several weeks
Negotiated price: $4,695
Price in 2023: $13,836
Price reduction: 66%

Fiasp/NovoLog

Description of the drug: This deal includes Fiasp, Fiasp FlexTouch, Fiasp PenFill, NovoLog, NovoLog FlexPen and NovoLog PenFill. These are insulin injections used to treat diabetes
Negotiated price: $119
Price in 2023: $495
Price reduction: 76%

When do Medicare drug prices go into effect?

These negotiated drug prices will go into effect for Medicare Part D beneficiaries on January 1, 2026. About 10 million Medicare enrollees used this set of 10 drugs in 2023 (combined), so it is expected that the lower prices they will have a wide impact.

Along with these drug prices, Part D beneficiaries will soon see other price changes. Starting in 2025, they will have a $2,000 cap on out-of-pocket costs, also as part of the Inflation Relief Act. This is one of the Medicare changes that will take place in 2025, and the cap may change after 2025.

What’s Next for Medicare Drug Price Negotiations?

This marks just the first set of Medicare drug price negotiations. Next year, Medicare will select up to 15 more drugs to negotiate for Part D beneficiaries. The following year, 2026, Medicare will select up to 15 more drugs to negotiate, and that will be for drugs covered by Part D or Part B .

The plan is for Medicare to continue to negotiate up to 20 drugs each year after 2026.

“We applaud this monumental milestone in limiting drug price increases and helping older adults afford their drugs while reducing costs to taxpayers,” the Center for Medicare Rights said of the announcement of the first set of negotiated prices. “The effect of these negotiations will develop year on year as more and more drugs are priced to better reflect their value.”

VaselineAugust 19, 2024

0 4 minutes read

Vaseline

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