HHS Announces Next 15 Drugs for Medicare Part D Price Negotiations

The US Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services, announced the 15 additional drugs for price negotiations under Medicare Part D. As per the Inflation Reduction Act, the negotiations with the manufacturers of the 15 drugs will occur in 2025, with the negotiated prices going into effect in 2027.¹

CMS, HSS, Negotiated Drug Prices, Inflation Reduction Act | Image Credit: Oleg | stock.adobe.com

“Last year we proved that negotiating for lower drug prices works. Now we plan to build on that record by negotiating for lower prices for 15 additional important drugs for seniors,” Xavier Becerra, secretary of HSS, said in a news release. “Today’s announcement is pivotal—the Inflation Reduction Act is lowering prices for people on Medicare. HHS will continue negotiating in the best interest of people with Medicare to have access to innovative, life-saving treatments at lower costs.”¹

According to HHS, the selected drugs, which include conditions such as cancer, type 2 diabetes, and asthma, accounted for approximately $41 billion in total gross covered prescriptions drug costs for Medicate Part D between November 2023 and October 2024. When combined with the initial 10 drugs selected, the cost represents over a third of the total gross covered prescription drug costs under Medicare Part D.¹

The selected drugs for the second cycle include¹:

• Semaglutide (Ozempic, Rybelsus, Wegovy; Novo Nordisk)
• Fluticasone furotate, umeclidinium, and vilanterol inhalation powder (Trelegy Ellipta; GSK)
• Enzalutamide (Xtandi; Astellas, Pfizer Oncology)
• Pomalidomide (Pomalyst; Bristol Myers Squibb)
• Palbociclib (Ibrance; Pfizer)
• Nintedanib (Ofev; Boehringer Ingelheim)
• Linaclotide (Linzess; AbbVie)
• Acalabrutinib (Calquence; AstraZeneca)
• Deutetrabenazine (Austedo, Austedo XR; Teva)
• Fluticasone furoate and vilanterol (Breo Ellipta; GSK)
• Linagliptin (Tradjenta; Boehringer Ingelheim)
• Rifaximin (Xifaxan; Salix Pharmaceuticals)
• Cariprazine (Vraylar; AbbVie)
• Stagliptin and metformin (Janumet, Janumet XR; Merck)
• Apremilast (Otezla; Amgen).

According to the news release, the drug companies with the selected drugs will have until February 28, 2025, to decide if they will participate in negotiation. CMS will consider the selected drug’s benefit for the Medicare population, as well as cost associated with research and development and production and distribution of the selected drugs.¹

In the future, CMS will select an additional 15 drugs for negotiation, including drugs that are covered under Part B and Part D for 2028, and up to 20 more drugs for each cycle after that.^1,2

In August 2023, CMS announced the first 10 drugs under negotiations. The first 10 selected drugs’ prices will go into effect on January 1, 2026. In August 2024, CMS announced the negotiated lower prices for the drugs that were selected during price negotiations.^2,3

The percentage discount for the first round of negotiated prices are as follows³:

• Apixaban (Eliquis; Bristol Myers Squibb): 56%
• Empagliflozin (Jardiance; Boehringer Ingelheim): 66%
• Rivaroxaban (Xarelto; Janssen Pharms): 62%
• Sitagliptin (Januvia; Merck Sharp Dohme): 79%
• Dapagliflozin (Farxiga; AstraZeneca AB): 68%
• Sacubitril/valsartan (Entresto; Novartis Pharms Corp): 53%
• Etanercept (Enbrel; Immunex Corporation): 67%
• Ibrutinib (Imbruvica; Pharmacyclics LLC): 38%
• Ustekinumab (Stelara; Janssen Biotech Inc): 66%
• Insulin aspart (including Fiasp, Fiasp FlexTouch, Fiasp PenFill, NovoLog, NovoLog Flexen, NovoLog PenFill; Novo Nordisk): 76%

REFERENCES

1. HHS Announces 15 Additional Drugs Selected for Medicare Drug Price Negotiations in Continued Effort to Lower Prescription Drug Costs for Seniors. News release. CMS. January 17, 2025. Accessed January 17, 2025. https://www.cms.gov/newsroom/press-releases/hhs-announces-15-additional-drugs-selected-medicare-drug-price-negotiations-continued-effort-lower

2. Ferruggia K. CMS Announces First 10 Drugs To Undergo Price Negotiations Under Inflation Reduction Act. Pharmacy Times. August 30, 2023. Accessed January 17, 2025. https://www.pharmacytimes.com/view/cms-announces-first-10-drugs-to-undergo-price-negotiations-under-inflation-reduction-act

3. Gallagher A. CMS Announces Negotiated Prices for 10 Drugs Under Inflation Reduction Act. Pharmacy Times. August 15, 2024. Accessed January 17, 2025. https://www.pharmacytimes.com/view/cms-announces-negotiated-prices-for-10-drugs-under-inflation-reduction-act