The Biden administration will submit proposed prices on Thursday for the first 10 drugs selected for Medicare's drug price negotiations, which the White House says will result in lower out-of-pocket costs for seniors.
The White House said the Centers for Medicare & Medicaid Services will notify drug companies Thursday of the proposed prices, and the companies then have 30 days to respond. Companies can either accept the government's proposed prices or counteroffer.
If companies do not agree with the government on pricing, the two sides will be required to negotiate pricing in the spring and summer of 2024. The prices would then go into effect in 2026.
The 10 medications up for negotiations include:
- Eliquis (prevention and treatment of blood clots)
- Jardiance (diabetes; heart failure)
- Xarelto (prevention and treatment of blood clots; reduction of risk for patients with coronary or peripheral artery disease)
- Januvia (diabetes)
- Farxiga (diabetes; heart failure; chronic kidney disease)
- Entresto (heart failure)
- Enbrel (rheumatoid arthritis; psoriasis; psoriasis arthritis)
- Imbruvica (blood cancers)
- Stelara (psoriasis; psoriatic arthritis; Crohn's disease, diabetes)
- Fiasp (diabetes)
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The White House said that these 10 drugs are among those with highest total spending in Medicare Part D.
The ability to allow Medicare to negotiate drug prices was included in the Inflation Reduction Act passed by Congress in 2022. The act also set a $2,000 price cap on out-of-pocket drug expenses for Medicare Part D enrollees.
Drugmakers that do not participate in negotiations would be required to withdraw their drugs from the Medicare program or pay an excise tax of at least 65% of their U.S. sales.
Drugmakers have objected to the law, as several filed lawsuits against the Biden administration in hopes of stopping the negotiations. In September, a federal judge decided not to block the White House's efforts to negotiate prescription prices. The case wasn't thrown out, however, meaning there remains some uncertainty that the proposed prices can actually go into effect.
After the first round of negotiations, the government will negotiate prices for 15 additional drugs in 2025, 15 more in 2026 and 20 in 2027. All told, Medicare is expected to negotiate pricing on 60 drugs over the next four years, with new prices going into effect by 2029.
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