The Biden administration on Friday announced the next round of prescription drugs selected for Medicare price negotiations, including Ozempic and Wegovy, top-selling diabetes and weight-loss drugs. The drugs have faced public backlash over their high prices, spurring demand for cheaper alternatives.
The list includes 15 drugs, up from 10 last year, and is the first step in a negotiation process between Medicare and drugmakers that is expected to take place in the coming months. The new negotiated prices will not take effect until 2027.
Still, deliberations under the Inflation Reduction Act of 2022 face an uncertain future under the incoming Trump administration, which has remained mum on whether it will support the government plan.
The drugs chosen for negotiation are:
Ozone; Rebelsus; Wegovy, for type 2 diabetes and weight loss.
Trelegy Ellipta, an asthma treatment drug.
Xtandi, for prostate cancer.
Pomalyst, a chemotherapy drug.
Ibrance, a breast cancer drug.
Ofev, treatment of idiopathic pulmonary fibrosis.
Linzess, a chronic constipation medication.
Calquence, an anti-cancer drug.
Austedo; Austedo XR, for Huntington’s disease.
Breo Ellipta, a COPD drug.
Tradjenta, a diabetes drug.
Xifaxan, for diarrhea and irritable bowel syndrome.
Vraylar, an antipsychotic drug.
Janumet; Janumet XR, diabetes drug.
Otezla, a drug used to treat psoriatic arthritis.
Juliette Cubanski, deputy director of the Medicare Policy Program at KFF, a nonprofit organization that studies health policy issues, said the risk for the government to reach a good deal this year is high.
A KFF survey released Friday found that more than half of the public said expanding the number of prescription drugs up for negotiation is a “top priority,” including nearly half of Republicans.
Ozempic and similar drugs are in high demand, and the cost to taxpayers is expected to increase as Medicare begins to cover FDA-approved drugs for other uses, such as heart disease risks. (Currently, Medicare is prohibited from covering weight-loss drugs.) “Having a hard bargain at the bargaining table could save Medicare billions of dollars in the coming years,” Cubanski said.
Drugmakers will have more than a month to agree to participate in negotiations or risk tax penalties. The only way to avoid the tax is to remove the drug from Medicare plans entirely, a move that would cost them huge market share.
An official from the Centers for Medicare and Medicaid Services said by phone that the government would begin contacting drugmakers later Friday to provide information about the negotiation process.
Asked whether the incoming Trump administration could pause or change the negotiations, the official said, “If they were to make changes in the future, it would require additional planning guidance, potential rulemaking and possibly new information-gathering requirements.” .
A spokesman for Novo Nordisk, the maker of Ozempic and Wegovy, said in a statement that the drugmaker remains opposed to pricing talks. Nonetheless, the spokesperson said it would work with the incoming administration to “deliver meaningful solutions for patients.”
According to CMS, approximately 5.3 million Medicare beneficiaries used these drugs between November 1, 2023, and October 1, 2024.
The 15 drugs selected collectively account for $41 billion, or 14%, of total Medicare Part D spending. Combined with the top 10 drugs that Medicare has negotiated, they account for one-third of all Part D spending, according to CMS data. Medicare Part D covers prescription drugs that people take on their own rather than in a facility, such as chemotherapy.
“We have an opportunity to negotiate a better deal for the American people,” outgoing Health and Human Services Secretary Xavier Becerra said in a call with reporters. “This is a big deal. Some people have to put it into perspective.” Halve the pills or skip a dose in the prescription to extend the validity of the prescription.”
Last year, Medicare reached a deal to lower prices on 10 of its most expensive drugs, including the blood thinner Eliquis; Imbruvica, a blood cancer treatment; and NovoLog, a diabetes drug.
The new prices for these drugs will take effect in 2026.
Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said including Ozempic this year is “a big deal.”
“This has significant budgetary implications for Medicare beneficiaries, Part D programs and taxpayers because over time it could significantly expand the use of these drugs among Medicare beneficiaries,” Dusetzina said. “If eligible beneficiaries begin using these products to lose weight, this could result in increased premiums because these products require long-term use.“
The pharmaceutical industry has vigorously fought the plan through lawsuits, but so far without success.
This article originally appeared on NBCNews.com
