On Oct. 3, the Biden Administration announced that all 10 drug companies whose drugs were selected for price negotiation with Medicare for the first cycle of the program have decided to participate in those negotiations. These companies manufacture some of the costliest and most commonly used prescription drugs.
These selected drugs accounted for $50.5 billion in total Part D gross covered prescription drug costs, or about 20%, of total Part D gross covered prescription drug costs between June 1, 2022 and May 31, 2023, which is the time period used to determine which drugs were eligible for negotiation. Medicare enrollees taking the 10 drugs covered under Part D selected for negotiation paid a total of $3.4 billion in out-of-pocket costs in 2022 for these drugs.
The landmark Inflation Reduction Act gave Medicare the authority to negotiate prescription drug prices for the first time in history, and, in late August, the U.S. Department of Health and Human Services (HHS) announced the 10 drugs covered under Medicare Part D selected for the first cycle of negotiation. Drug companies that manufacture these drugs have indicated that they will participate in negotiations with Medicare during the remainder of 2023 and in 2024, and any agreed-upon negotiated prices will become effective beginning in 2026.
“We are pleased that all 10 drug companies will participate in Medicare drug price negotiations. We look forward to continuing this critical work to lower health care costs for the American people and ensure seniors don’t have to choose between paying for prescription drugs or putting food on the table,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration wants Americans with Medicare to have access to innovative, life-saving treatments. Negotiating provides us a critical tool to ensure they get those prescription drugs at lower prices – just as the U.S. Department of Veterans Affairs has done for years.”
The Biden-Harris Administration has made lowering prescription drug costs and improving access to innovative therapies a key priority. Alongside other provisions in the new law that increase the affordability of health care and prescription drugs, allowing Medicare to negotiate prescription drug prices will strengthen the program’s ability to serve people with Medicare now and for generations to come. The negotiation process will consider the selected drug’s clinical benefit, the extent to which it fulfills an unmet medical need, and its impact on people who rely on Medicare, among other considerations, such as costs associated with research and development as well as costs associated with production and distribution. As a result of negotiations, people with Medicare will have access to innovative, life-saving treatments at lower costs to Medicare and taxpayers.
CMS will publish any agreed-upon negotiated prices for the selected drugs by September 1, 2024; those prices will become effective starting January 1, 2026. In future years, CMS will select for negotiation up to 15 more drugs covered under Part D for 2027, up to 15 more drugs for 2028 (including drugs covered under Part B and Part D), and up to 20 more drugs for each year after that, as required by the Inflation Reduction Act.
View a fact sheet from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at: https://aspe.hhs.gov/reports/aspe-ira-drug-negotiation-fact-sheet.
View a CMS fact sheet on the drugs selected for the Medicare Drug Price Negotiation Program at: https://www.cms.gov/files/document/fact-sheet-medicare-selected-drug-negotiation-list-ipay-2026.pdf - PDF.
More information on the Medicare Drug Price Negotiation Program is available at https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-price-negotiation.
HHS has the press release that includes the list of companies participating in the Medicare Drug Price Negotiation Program.