HHS Announces Next 15 Drugs for Medicare Part D Price Negotiations

The U.S. Department of Health and Human Services (HSS), through the Centers for Medicare and Medicaid Services, announced 15 additional drugs that will be subject to price negotiation under Medicare Part D. In accordance with the Inflation Suppression Act, negotiations with 15 drug manufacturers have been concluded. It is expected to be realized in 2025 and the negotiated price will take effect in 2027.¹

CMS, HSS, Negotiated Drug Prices, Inflation Control Act | Image credit: Oleg | stock.adobe.com

“Last year, we proved that negotiating drug prices down is effective, and we plan to build on that record by negotiating down prices on 15 additional critical medicines for seniors.” HSS Secretary Xavier Becerra said in a news release. “Today's announcement is extremely important. The Inflation Control Act will lower prices for people on Medicare. We will continue to negotiate with this as our top priority.”¹

According to HHS, select drugs, including those for diseases such as cancer, type 2 diabetes, and asthma, will account for approximately $41 billion of total prescription drugs covered by Medicare Part D from November 2023 to October 2024. occupied. The cost of the 10 selected drugs represents more than one-third of the total prescription drug costs covered by Medicare Part D.¹

Drugs selected for the second cycle include:¹:

• Semaglutide (Ozempic, Rybelsus, Wegovy, Novo Nordisk)
• Fluticasone furoate, umeclidinium, vilanterol inhalation powder (Trelegy Ellipta; GSK)
• Enzalutamide (Xtandi, Astellas Pharma, Pfizer Oncology)
• Pomalidomide (Pomalyst; Bristol-Myers Squibb)
• Palbociclib (Ibrance; Pfizer)
• Nintedanib (Ofev; Boehringer Ingelheim)
• Linaclotide (Linzess; AbbVie)
• Acalabrutinib (Calquence; AstraZeneca)
• Deutetrabenazine (Austed, Austed XR, Teva)
• Fluticasone furoate and vilanterol (Breo Ellipta; GSK)
• Linagliptin (Tradjenta, Boehringer Ingelheim)
• Rifaximin (Xifaxan, Salix Pharmaceuticals)
• Cariprazine (Vraylar; AbbVie)
• Stagliptin and metformin (Janumet, Janumet XR, Merck)
• Apremilast (Otezla, Amgen).

Pharmaceutical companies supplying the selected drugs have until February 28, 2025, to decide whether to participate in negotiations, according to a news release. CMS considers not only the benefits of the selected drug to the Medicare population, but also the costs associated with research and development, production, and distribution of the selected drug.¹

Going forward, CMS will select an additional 15 drugs for negotiation, including drugs covered by Part B and Part D in 2028, and up to an additional 20 drugs each cycle thereafter. It's planned.^1,2

In August 2023, CMS announced the first 10 drugs under negotiation. Prices for the first 10 medicines selected will take effect on January 1, 2026. In August 2024, CMS announced negotiated prices for drugs selected in price negotiations.^{2, 3}

The discount percentage for the initial negotiated price is:³:

• Apixaban (Eliquis, Bristol-Myers Squibb): 56%
• Empagliflozin (Jardiance, Boehringer Ingelheim): 66%
• Rivaroxaban (Xarelto; Janssen Pharms): 62%
• Sitagliptin (Januvia, Merck Sharp Dohme): 79%
• Dapagliflozin (Farxiga, AstraZeneca AB): 68%
• Sacubitril/Valsartan (Entresto; Novartis Pharms Corp): 53%
• Etanercept (Enbrel; Immunex Corporation): 67%
• Ibrutinib (Imbruvica, Pharmacyclics LLC): 38%
• Ustekinumab (Stelara; Janssen Biotech Inc): 66%
• Insulin Aspart (includes Fiasp, Fiasp FlexTouch, Fiasp PenFill, NovoLog, NovoLog Flexen, NovoLog PenFill, Novo Nordisk): 76%

References

1. In its continued effort to lower prescription drug costs for seniors, HHS announced that it has selected 15 additional drugs for Medicare drug price negotiations. News release. CMS. January 17, 2025. Accessed January 17, 2025. https://www.cms.gov/newsroom/press-releases/hhs-announces-15-Additional-drugs-selected-medicare-drug-price-negotiations-Continuoused-effort – Lower

2. Ferruggia K. CMS announces first 10 drugs subject to price negotiations under the Inflation Control Act. pharmacy times. August 30, 2023. Accessed January 17, 2025. https://www.pharmacytimes.com/view/cms-announces-first-10-drugs-to-undergo-price-negotiations-under-inflation-reduction-act

3. Gallagher A. CMS releases negotiated prices for 10 drugs under the Inflation Control Act. pharmacy times. August 15, 2024. Accessed January 17, 2025. https://www.pharmacytimes.com/view/cms-announces-negotiated-prices-for-10-drugs-under-inflation-reduction-act