White House Sets Medicare Price Negotiation Targets

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The Centers for Medicare & Medicaid Services (CMS) has announced the first 10 drugs covered under Medicare Part D selected for negotiation.

The Centers for Medicare & Medicaid Services (CMS) announced the first 10 drugs whose prices will be directly negotiated with drug companies on Aug. 29, 2023. According to an agency press release, these negotiations will occur during 2023 and 2024, with any negotiated prices coming effective at the start of 2026.

The most commonly treated conditions in the list include diabetes, heart disease, blood clots, arthritis, and psoriasis. According to a fact sheet released by the agency, the full list of drugs is:

  • Eliquis (apixaban), intended for prevention and treatment of blood clots.
  • Jardiance (empagliflozin), intended for treatment of diabetes and heart disease.
  • Xarelto (rivaroxaban),  intended for prevention and treatment of blood clots, as well as reduction of risk for patients with coronary or peripheral artery disease.
  • Januvia (sitagliptin), intended for treatment of diabetes.
  • Farxiga (dapagliflozin), intended for treatment of diabetes, heart disease, and chronic kidney disease.
  • Entresto (sacubitril/valsartan), intended for treatment of heart failure.
  • Enbrel (etanercept), intended for treatment of rheumatoid arthritis, psoriasis, and psoriatic arthritis.
  • Imbruvica (ibrutinib), intended for treatment of blood cancers.
  • Stelara (ustekinumab), intended for treatment of psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis
  • Fiasp and Novolog (insulin aspart), as well as various derivatives, intended for treatment of diabetes.

Of that list, apixaban affected the greatest number of Medicare patients from June 2022 to May 2023, with approximately 3.7 million patients; it also had the highest bill, approximately $16.4 billion, of the selected medicines. Ibrutinib had the smallest patient population in that timeframe, at approximately 20,000, while insulin aspart and its derivatives had the lowest price tag of approximately $2.5 billion. In total, the selected drugs comprised approximately 8.2 million patients at a price tag of $50.5 billion, according to the fact sheet.

According to the press release, CMS encourages the public to submit input on the medicines selected for negotiation. CMS also plans to host a series of patient-focused listening sessions this fall as part to provide an opportunity for patients, beneficiaries, caregivers, consumer and patient organizations, and other interested parties to share input relevant to drugs selected for the first cycle of negotiations.

Source: CMS