番茄社区

Sitagliptin (Januvia) saw the greatest drop in price among the whose new prices were announced Thursday under Medicare's .

The price negotiation program was passed in 2022 as part of the Inflation Reduction Act (IRA). The measure lowers prescription drug costs for seniors by empowering Medicare to negotiate the cost of prescription drugs. The price for sitagliptin, a type 2 diabetes drug, dropped from $527 for a 30-day supply to $113, a 79% decrease. The other nine drugs whose prices were announced Thursday included:

• Insulin aspart injection (NovoLog, among others): for diabetes mellitus; original price $495, negotiated price $119 (76% decrease)
• Dapagliflozin (Farxiga): for type 2 diabetes, heart failure, and chronic kidney disease; original list price $556, negotiated price $179 (68% decrease)
• Etanercept (Enbrel): for rheumatoid arthritis; original list price $7,106 [$1,777 per weekly dose], negotiated price $2,355 (67% decrease)
• Empagliflozin (Jardiance): for type 2 diabetes and heart failure; original list price $573, negotiated price $197 (66% decrease)
• Ustekinumab (Stelara): for Crohn's disease, ulcerative colitis, psoriasis, and psoriatic arthritis; original list price $13,836, negotiated price $4,695 (66% decrease)
• Rivaroxaban (Xarelto): to prevent blood clots and reduce risks for patients with coronary or peripheral artery disease; original list price $517, negotiated price $197 (62% decrease)
• Apixaban (Eliquis): to prevent stroke and blood clots; original list price $521, negotiated price $231 (56% decrease)
• Sacubitril/valsartan (Entresto): for chronic heart failure; original list price $628, negotiated price $295 (53% decrease)
• Ibrutinib (Imbruvica): for chronic lymphocytic leukemia/small lymphocytic lymphoma and other blood cancers; original list price $14,934, negotiated price $9,319 (38% decrease)

"Americans pay way too much for their prescription drugs; that's what makes today's announcement so historic," HHS Secretary Xavier Becerra said on a phone call with reporters Wednesday night. "For the first time ever, Medicare negotiated directly with drug companies, and the American people are better off for it."

No Blank Check for Big Pharma, Biden Says

At a rally in Maryland on Thursday afternoon, President Biden said the first time he cosponsored legislation to let Medicare negotiate prescription drug prices was in 1973 when he was a senator. "I've been waiting for this moment for a long, long time," he said. "It's about your dignity, your peace of mind ... It's about giving folks breathing room."

Biden said that Project 2025, a conservative policy blueprint for the federal government that was written by a group that included many former Trump administration officials, the price negotiation program [p. 465], and also seeks to make cuts to Medicare and Social Security.

"Let me tell you what our Project 2025 is: beat the hell out of 'em," Biden said to loud applause. "Our Project 2025 will lower drug costs for you and your family... instead of handing Big Pharma a big blank check."

The negotiated prices will take effect beginning Jan. 1, 2026. "In our first year of negotiations, we are saving Medicare $6 billion," Becerra said; the figure is based on what Medicare would have paid for drugs in 2023 had the negotiated prices been in effect. "And on top of that, Americans who pay out-of-pocket costs in Medicare for their prescription drugs will be saving another $1.5 billion moving forward."

Part B Drugs Will Be Added

The 10 drugs chosen for negotiation by CMS -- single-source brand-name drugs with no therapeutically equivalent generic or biosimilar competition -- were targeted for negotiation based on their total expenditures in the Medicare Part D program. These drugs are either costly, widely used, or both. Apixaban, for example, was used by nearly 4 million Medicare beneficiaries in 2023, bringing the total cost last year to over $18 billion.

Looking ahead, CMS will choose up to 15 additional drugs for price negotiation for 2027, up to 15 more drugs (to include drugs covered under Medicare Part B) for 2028, and up to 20 more drugs for price negotiation each year after that, as stated in the IRA.

For the upcoming negotiations on Part B drugs, which are dispensed in physician offices, "we've built a strong foundation to build on for future negotiations," Stacy Sanders, HHS Chief Competition Officer, told 番茄社区 during a phone interview at which a press person was present. "The focus of this administration really has been about making sure that patients -- the people who need the medications, are able to afford those medications."

"The driving principle behind the work we're doing is to assure affordability and ensure access. That will be true for future negotiations too," Sanders added.

To that end, the agency will monitor to make sure that Medicare beneficiaries have access to the negotiated drugs and aren't being steered to other drugs by the plans, she said. "CMS has been clear in their guidances that they'll engage in a robust formulary review process" for Part D plans. "We know under the law these negotiated prescription drugs must be covered. We'll continue to keep access and affordability at the center of our decision-making."

Lots of Back and Forth

Some opponents of the price negotiations have complained that although CMS said it took into account each drug's research and development costs when it was negotiating prices, the agency didn't account for the fact that for every drug that makes it to market, there are dozens of others that the drug company spends money looking into but has to abandon.

"Research and development costs were one among many things that we took into consideration as we engaged in negotiations with the drug manufacturers," Sanders said when 番茄社区 asked about this criticism. "We strongly believe that we can implement these programs and still secure innovation in the market. The manufacturing industry is strong and thriving. We believe drug companies will continue to profit."

On a call with reporters Thursday, senior administration officials gave a brief glimpse of the negotiating process. "The negotiations were a genuine back and forth with the participating drug companies, and we learned a lot of valuable information in the negotiation meetings," one official said. "Some of the topics discussed [included] the selected drug's clinical benefit and how a selected drug benefits people with Medicare and the Medicare program, as well as therapeutic alternatives for the selected drug and how they should inform the negotiated price."

"For five of the selected drugs, we reached an agreement on a negotiated price in association with one of those negotiation meetings," the official continued. "And for the remaining five selected drugs, we sent a written final offer to those drug companies, and each company accepted that written final offer."

More information about the negotiations will be forthcoming when CMS releases a more detailed explanation of how the prices were arrived at, including the data CMS received, the exchange of offers and counter-offers, and more information on the negotiation meetings; by law, that information must be released by March 1 of next year, the official said.

This is not necessarily the end of the matter, however. Drugmakers and lobbyists have filed 10 separate lawsuits objecting to the negotiation program. Five lawsuits filed by drug companies have been dismissed in federal court;

Comment