Next Set of Drugs Selected for Medicare Drug Price Negotiation

On Jan. 17, the Department of Health and Human Services (HHS) and CMS announced the next set of selected drugs under the Medicare Drug Price Negotiation Program. The second set of negotiations with participating drug companies for these 15 drugs will occur in 2025 and any negotiated prices will become effective in 2027. The list includes: Austedo, Austedo XR; Breo Ellipta; Calquence; Ibrance; Janumet; Janumet XR; Linzess; Ofev; Otezla; Ozempic, Rybelsus, Wegovy; Pomalyst; Tradjenta; Trelegy Ellipta; Vraylar; Xifaxan; and Xtandi.

The agencies state: “Between Nov. 2023 and Oct. 2024, about 5.3 million people with Medicare Part D coverage used these drugs to treat a variety of conditions, such as cancer, type 2 diabetes, and asthma. These selected drugs accounted for about $41 billion in total gross covered prescription drug costs under Medicare Part D, or about 14%, during that time period.” Manufacturers with a selected drug will have until Feb. 28 to decide if they will participate in negotiations. 

Relatedly, on Jan. 29, CMS released a statement saying, “as the second cycle begins under the Trump Administration, CMS is committed to incorporating lessons learned to date from the program and considering opportunities to bring greater transparency in the Negotiation Program.” CMS also noted it intended to provide opportunities for stakeholders to “provide specific ideas to improve the Negotiation program.”