The U.S. Division of Well being and Human Companies unveiled 15 further medicine chosen for the Medicare Drug Value Negotiation Program on Friday. Many healthcare leaders are applauding the listing of chosen medicine, whereas drug producers are popping out towards it.
Underneath this system, which was created via the Inflation Discount Act, the federal authorities is ready to negotiate the value of chosen medicine with taking part drug corporations. The primary 10 medicine have been introduced in August 2023 and the negotiated costs will go into impact in 2026. Negotiations for the following 15 medicine will happen this yr and the negotiated costs will go into impact in 2027.
The extra medicine chosen for this system are:
- Ozempic; Rybelsus; Wegovy
- Trelegy Ellipta
- Xtandi
- Pomalyst
- Ibrance
- Ofev
- Linzess
- Calquence
- Austedo; Austedo XR
- Breo Ellipta
- Tradjenta
- Xifaxan
- Vraylar
- Janumet; Janumet XR
- Otezla
These medicine accounted for about $41 billion in complete gross coated prescription drug prices beneath Medicare Half D between November 2023 and October 2024, in response to HHS. As well as, throughout the identical time interval, about 5.3 million folks with Medicare Half D protection used these medicine for circumstances like most cancers, kind 2 diabetes and bronchial asthma.
Whereas HHS is touting this system and extra listing of medication as a method to cut back drug costs, among the drug producers chosen for this system say this system is inflicting extra hurt than good. For instance, Pfizer, the producer of Ibrance, argued in a press release that the Inflation Discount Act “establishes a harmful price-setting system that enables the federal government to dictate the worth and worth of sure medicines, discouraging continued growth.”
Novo Nordisk — the producer of Wegovy, Ozempic and Rybelsus — additionally got here out towards the listing of further medicine for this system.
“Novo Nordisk stays against authorities worth setting via the IRA and has important considerations about how the regulation is being applied by this administration, together with aggregating a number of merchandise that individually wouldn’t meet the necessities of the statute,” a spokesperson mentioned in an e mail.
It’s price noting that a number of drug corporations (together with Novo Nordisk) have filed lawsuits towards the drug worth negotiation program. Teva Prescribed drugs is the most recent to take action.
Whereas producers oppose HHS’ announcement, AARP, a nonprofit for Individuals aged 50 and older, applauded the listing of further medicine chosen for the negotiation program.
“For too lengthy, large drug corporations have padded their earnings by setting outrageous costs on the expense of American lives, forcing seniors to skip prescriptions they’ll’t afford. … With Medicare negotiating to decrease costs on extra medicine and the brand new out-of-pocket cap, seniors are lastly beginning to see reduction from excessive drug costs,” mentioned Nancy LeaMond, AARP govt vp and chief advocacy and engagement officer, in a press release.
Sufferers for Reasonably priced Medicine, a affected person advocacy group, additionally celebrated the announcement, stating that it’ll decrease prices for thousands and thousands of sufferers. Nevertheless, extra work is required to guard the negotiation program, in response to Merith Basey, govt director of Sufferers for Reasonably priced Medicine.
“Let’s be clear: we should maintain pushing to increase the wildly in style Medicare negotiation program,” Basey mentioned in a press release. “Sufferers fought extraordinarily laborious for the passage of those reforms and so they proceed to vigorously defend them towards pharma’s assaults – as a result of no person ought to have to decide on between life-saving medicine and their fundamental wants.”
One healthcare govt — Brooke Boyarsky Pratt, founder and CEO of knownwell — is especially excited concerning the number of Ozempic and Wegovy for the negotiation program. The corporate presents metabolic well being providers, main care, vitamin counseling and well being teaching.
“Value negotiations for Ozempic and Wegovy have the potential to utterly change affected person entry to complete weight problems care,” Boyarsky Pratt informed MedCity Information. “As has been mentioned at size, the query about GLP-1s is about their affordability, not their efficacy. HHS has the chance to make these drugs reasonably priced for these residing with weight problems throughout America and pave the best way for industrial plans to cowl these medicines at scale.”
Picture: cagkansayin, Getty Photos