Prescription drug costs.Cagkan Sayin/Adobe Stock
Building on the success of the first round of the Centers for Medicare & Medicaid Services price negotiations last year, the agency has announced the selection of 15 drugs, up from 10 in the first round, for Round 2 of the negotiations with top drugmakers – and popular GLP-1 weight loss drugs, Ozempic, Wegovy and Rybelsus, are in the mix.
Medicare, which has selected the following 15 drugs (listed in order of covered drug costs from November 2023 to October 2024) to negotiate directly with participating drug companies, aims to lower prices for these costly prescription drugs:
- Ozempic; Rybelsus; Wegovy, for Type 2 diabetes and weight loss (Novo Nordisk)
- Trelegy Ellipta, an asthma treatment (GSK)
- Xtandi, for prostate cancer (Pfizer)
- Pomalyst, a chemotherapy drug (Bristol-Myers Squibb)
- Ibrance, a breast cancer drug (Pfizer)
- Ofev, for idiopathic pulmonary fibrosis (Boehringer Ingelheim)
- Linzess, a chronic constipation drug (AbbVie)
- Calquence, a cancer drug (AstraZeneca)
- Austedo; Austedo XR, for Huntington’s disease (Teva)
- Breo Ellipta, a COPD drug (GSK)
- Tradjenta, a diabetes drug (Boehringer Ingelheim)
- Xifaxan, for diarrhea and irritable bowel syndrome (Salix)
- Vraylar, an antipsychotic drug (AbbVie)
- Janumet; Janumet XR, diabetes drugs (Merck)
- Otezla, a psoriatic arthritis drug (Amgen)
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Manufacturers of each chosen drug for the second round must decide whether they want to negotiate with the CMS by Feb. 28. Some of the top drugmakers included in this second round include: Novo Nordisk (which is the drugmaker for Ozempic, Rybelsus and Wegovy), Pfizer (which makes Xtandi, in collaboration with Astellas) and GlaxoSmithKline (which manufactures Trelegy Ellipta). Drugmakers who opt out of the negotiations face a significant financial penalty.
In 2023, after the first 10 drugs were announced for the Medicare program, drugmakers Merck, Bristol Myers Squibb, Johnson & Johnson and others, as well as the Chamber of Commerce and the Pharmaceutical Research and Manufacturers of America filed lawsuits challenging the program, calling the plan "extortion." However, most of these efforts were largely unsuccessful.
Related: Done deal! Big Pharma will cut prices of 10 drugs in Medicare price negotiation program
During the second cycle of negotiations, CMS will hold up to 15 patient-focused roundtable events, as well as one town hall meeting, to solicit feedback from interested parties, focused on the clinical considerations related to the selected drugs.
“We are continuing to implement the prescription drug law thoughtfully, prioritizing engagement with all interested parties, and ensuring the process is as transparent … as possible," said Dr. Meena Seshamani, MD, PhD, CMS Deputy Administrator and Director of the Center for Medicare.
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Lynn Cavanaugh
Lynn Varacalli Cavanaugh is Senior Editor, Retirement at BenefitsPRO. Prior, she was editor-in-chief of the What's New in Benefits & Compensation newsletter. She has worked for major firms in the employee benefits space, Vanguard and Willis Towers Watson, as well as top media companies, including Condé Nast and American Media.
