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In its last weekday, the Biden administration has revealed the next round of medicines subject to government price negotiations.
It’s the latest step for a controversial program created under the 2022 Inflation Reduction Act (IRA) that lets the Centers for Medicare and Medicaid Services (CMS) work with drugmakers to determine lower costs for select Medicare Part D drugs.
CMS announced the first 10 drugs in August 2023, and the updated prices for those will go into effect at the start of 2026. For the 15 new drugs, price negotiations will happen this year and the new prices will take effect in 2027, according to the agency.
The new list includes:
- Ozempic, Rybelsus, Wegovy (Novo Nordisk, Type 2 diabetes and obesity)
- Trelegy Ellipta (GSK, chronic obstructive pulmonary disease)
- Xtandi (Astellas Pharma and Pfizer, prostate cancer)
- Pomalyst (Bristol Myers Squibb, AIDS-related Kaposi sarcoma)
- Ibrance (Pfizer, breast cancer)
- Ofev (Boehringer Ingelheim, lung disease)
- Linzess (Ironwood Pharmaceuticals, irritable bowel syndrome with constipation)
- Calquence (AstraZeneca, mantle cell lymphoma)
- Austedo, Austedo XR (Teva Pharmaceuticals, Huntington’s disease-related chorea and tardive dyskinesia)
- Breo Ellipta (GSK and Theravance, asthma)
- Tradjenta (Boehringer Ingelheim, Type 2 diabetes)
- Xifaxan (Salix Pharmaceuticals, irritable bowel syndrome with diarrhea)
- Vraylar (AbbVie, major depressive disorder)
- Janumet, Janumet XR (Merck, Type 2 diabetes)
- Otezla (Amgen, psoriasis and psoriatic arthritis)
About 5.3 million Medicare Part D beneficiaries used these drugs between November 2023 and October 2024, which accounted for roughly $41 billion in gross prescription drug costs, or 14% of total Part D spend, CMS said.
To determine the new prices, CMS said it will consider factors including the drugs’ clinical benefits and whether they meet unmet medical needs.
Varying responses. AARP, the nonprofit that represents older US adults, voiced support for the price negotiations.
"For too long, big drug companies have padded their profits by setting outrageous prices at the expense of American lives, forcing seniors to skip prescriptions they can’t afford,” Nancy LeaMond, AARP’s EVP and chief advocacy and engagement officer, said in a statement.
But PhRMA, the drug industry’s largest lobbying group, has been a vocal opponent.
“The IRA price setting process is dangerous for millions of Americans who rely on innovative treatments and created unnecessary, costly bureaucracy,” Stephen Ubl, PhRMA’s president and CEO, said in a statement.
What’s next? In 2026, CMS can select up to 15 more drugs for price negotiations, and up to 20 every year after that.
However, the fate of the program is unclear, as Republican lawmakers have repeatedly stated they aim to roll back the IRA. The incoming Trump administration has not publicly said if it plans to repeal drug price negotiations, Healthcare Brew previously reported.