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Medicare can now negotiate prices on these drugs to help seniors save

Ten drugs are slated to have their prices slashed for Medicare recipients, but the drug industry is objecting to the new law.
Medicare can now negotiate prices on these drugs to help seniors save
Posted at 6:12 AM, Aug 29, 2023

The Biden administration announced the first 10 drugs selected for Medicare's drug price negotiations, which the White House says will result in lower out-of-pocket costs for seniors. 

The White House said negotiations on the first 10 drugs will begin this year with negotiated prices going into effect in 2026. 

The 10 drugs announced:

- Eliquis (prevention and treatment of blood clots)

- Jardiance (diabetes; heart failure)

- Xarelto (prevention and treatment of blood clots; reduction of risk for patients with coronary or peripheral artery disease)

- Januvia (diabetes)

- Farxiga (diabetes; heart failure; chronic kidney disease)

- Entresto (heart failure)

- Enbrel (rheumatoid arthritis; psoriasis; psoriasis arthritis)

- Imbruvica (blood cancers)

- Stelara (psoriasis; psoriatic arthritis; Crohn's disease, diabetes)

- Fiasp (diabetes)

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The average cost per Part D enrollee can vary. For the drug Fiasp, the average cost is $3,316 per year. But for a drug like Imbruvica, the average cost is $133,951 for the nearly 22,000 Part D enrollees, according to the White House.

The White House said that these 10 drugs are among those with highest total spending in Medicare Part D.

"When implemented, prices on negotiated drugs will decrease for up to 9 million seniors," President Joe Biden said in a statement. "These seniors currently pay up to $6,497 in out-of-pocket costs per year for these prescriptions. In addition, the nonpartisan Congressional Budget Office reports that this will save taxpayers $160 billion by reducing how much Medicare pays for drugs through negotiation and inflation rebates."

After the first round of negotiations, the government will negotiate prices for 15 additional drugs in 2025, 15 more in 2026 and 20 in 2027. All told Medicare is expected to negotiate pricing on 60 drugs over the next four years, with new prices going into effect by 2029. 

Drugmakers that do not participate in negotiations would be required to withdraw their drugs from the Medicare program or pay an excise tax of at least 65% of their U.S. sales. 

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The ability to allow Medicare to negotiate drug prices was included in the Inflation Reduction Act passed by Congress last year. The act also set a $2,000 price cap on out-of-pocket drug expenses for Medicare Part D enrollees. 

Drugmakers are objecting to the law, as several have filed lawsuits against the Biden administration in hopes of stopping the negotiations. 

"Today’s announcement is the result of a rushed process focused on short-term political gain rather than what is best for patients," said the Pharmaceutical Research and Manufacturers of America in a statement. "Many of the medicines selected for price setting already have significant rebates and discounts due to the robust private market negotiation that occurs in the Part D program today. Giving a single government agency the power to arbitrarily set the price of medicines with little accountability, oversight or input from patients and their doctors will have significant negative consequences long after this administration is gone."

The drugmakers added, "The harm will spread beyond cancer and impact people with rare diseases, mental health illnesses and other terrible diseases."

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