The medications – which include the blood thinner Eliquis and the rapid-acting insulin Fiasp/Novolog – cost Medicare around $50 billion from June 1, 2022, to May 31, 2023, according to the Centers for Medicare and Medicaid Services, or CMS.
Last year, people enrolled in Medicare had to spend $3.4 billion in out-of-cost expenses for those 10 drugs, which are among those with the highest total spending in Medicare Part D and are used to treat life-threatening conditions including diabetes, heart failure, and cancer.
They are Eliquis; Jardiance; Xarelto; Januvia; Farxiga, Entresto; Enbrel; Imbruvica; Stelara; and Fiasp/Novolog.
Many seniors enrolled in Medicare “struggle to access their medications because of prohibitive costs,” the White House said in a news release.
“No senior should have to overpay for life-saving drugs to pad Big Pharma’s pockets,” President Joe Biden said in a statement. “We’re ending the days of deciding between buying your medicine or putting food on the table.”
According to the program, which seeks to reduce the federal government’s spending on prescription medication, drug manufacturers will negotiate the new prices with the federal government over the next few months. The new, renegotiated prices will come into effect on Jan. 1, 2026.
“For far too long, pharmaceutical companies have made record profits while American families were saddled with record prices and unable to afford life-saving prescription drugs,” HHS Secretary Xavier Becerra said in a statement. “But thanks to the landmark Inflation Reduction Act, we are closer to reaching President Biden’s goal of increasing availability and lowering prescription drug costs for all Americans.”
Drug makers have vehemently opposed the Inflation Reduction Act’s Medicare drug price negotiation program since it was signed into law last year. Several lawsuits have been filed in federal courts arguing the new provisions are unconstitutional.
Stephen Ubl, the head of the Pharmaceutical Research and Manufacturers of America (PhRMA), the industry’s major lobbying group, slammed Tuesday’s announcement as “the result of a rushed process focused on short-term political gain rather than what is best for patients.”
He said several medicines selected for price negotiation already have “significant rebates and discounts due to the robust private market negotiation that occurs in the Part D program today,” and leaving the process up to the government would hurt investment and innovation.
“Giving a single government agency the power to arbitrarily set the price of medicines with little accountability, oversight or input from patients and their doctors will have significant negative consequences long after this administration is gone,” Ubl added.
In future years, CMS can negotiate prices for 15 other drugs for 2027, an additional 15 in 2028, and up to 20 more medications for each year after that, as outlined in the Inflation Reduction Act.