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White House announces ‘Big Pharma’ is in for Medicare prescription drug price negotiations


CMS to make offer in February 2024 for prices to take effect in 2026.

health care high drug prices: © Nuthawut - stock.adobe.com

© Nuthawut - stock.adobe.com

Pharmaceutical makers of widely used drugs in Medicare will head to the bargaining table with federal officials.

On Oct. 3, President Joe Biden announced the makers of 10 drugs selected for price talks have agreed to participate in the Medicare Drug Price Negotiation Program, approved in August 2022 in the federal Inflation Reduction Act.

The medicines, used for conditions such as heart failure, diabetes and arthritis, accounted for a total of $3.4 billion in out-of-pocket costs for an estimated 9 million Medicare enrollees in 2022, according to the White House. Once the dickering is done, the new prices will go into effect in 2026.

“We look forward to engaging with the drug manufacturers of the selected drugs that have decided to participate in the Medicare Drug Price Negotiation Program,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “Our goal is to ensure access to innovative treatments and therapies for people that need them when they need them. Medicare will negotiate in good faith consistent with the requirements of the law on behalf of people with Medicare.”

In August, the U.S. Centers for Medicare & Medicaid Services (CMS) announced the first 10 drugs selected for price talks. Pharmaceutical makers had until Oct. 1 to notify CMS of their intention to participate and Oct. 2 was the deadline to send manufacturer-specific data to CMS.

The manufacturers; prescription drug name,s and commonly treated conditions; patients affected; and average out-of-pocket cost per Medicare Part D enrollee in 2022, are:

  • Bristol Myers Squibb; Eliquis, prevention and treatment of blood clots; 3.71 million; $608
  • Boehringer Ingelheim; Jardiance, diabetes and heart failure; 1.57 million; $490
  • Janssen Pharms, Xarelto, prevention and treatment of blood clots and reducing risk of coronary or peripheral artery disease; 1.33 million; $617
  • Merck Sharp Dohme; Januvia, diabetes; 869,000; $502
  • AstraZeneca AB; Farxiga, diabetes, heart failure and chronic kidney disease; 799,000; $448
  • Novartis Pharms Corp.; Entresto, heart failure; 587,000; $569
  • Immunex Corp.; Enbrel, rheumatoid arthritis, psoriasis, psoriatic arthritis; 48,000; $2,005
  • Pharmacyclics LLC; Imbruvica, blood cancers; 20,000; $6,497
  • Jannssen Biotech Inc.; Stalara, psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis; 22,000; $4,207
  • Novo Nordisk Inc.; Fiasp, Fiasp Flex Touch, Fiasp PenFill, NovoLog, Novolog FlexPen, NovoLog PenFill, diabetes; 777,000; $261

The Congressional Budget Office has estimated dickering for drug prices will save Medicare close to $100 billion in the next 10 years.

The concept has broad support from the public, but basically zero support from pharmaceutical companies suing to stop the price talks. It was unclear whether the Oct. 3 announcement would affect the pending litigation.

Last month, House Republicans held a hearing on the legality and fairness of the drug price negotiations, with witnesses who argued the plan could stifle research and reduce medicine availability. Democrats fired back that the GOP was kowtowing to Big Pharma.

The White House announcement of Oct. 3 included statements, facts and figures about the administration’s efforts to rein in prescription drug costs for seniors.

“For decades, Big Pharma fought to block Medicare from directly negotiating lower drug prices for seniors and other Medicare beneficiaries, while nearly three in 10 Americans struggle to afford their medications because of cost,” said the announcement posted in the White House Briefing Room. “President Biden and Congressional Democrats finally beat Big Pharma and allowed Medicare to directly negotiate lower drug prices by passing the Inflation Reduction Act – despite zero Republicans voting in favor of the bill.”

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