Here’s a list of the drugs selected for renegotiation,extracted from the provided text:
* Entresto (sacubitril/valsartan; Novartis)
* januvia (sitagliptin; Merck)
* Eliquis (apixaban; Bristol Myers Squibb)
* Entages (200 Pharmaceutical Section)
* Erleada (apalutamide; Janssen Biotech)
* Kisqali (ribociclib; Novartis)
* Lenvima (Lenvatinib mesylate; Eisai Co)
* Orencia (abatacept; Bistol Myers Squibb)
* Rexulti (brexpiprazole; otsuka Pharmaceutical Co)
* Trulicity (dulaglutide; Eli Lilly)
* Verzenio (abemaciclib; Eli Lilly)
* Xelianz; Xeljanz XR (tofacitinib; Pfizer)
* Xolair (omalizumab; Genentech,Novartis)
* Tradjenta (linagliptin; Boehringer Ingelheim) (selected for renegotiation)
What drugs are included in the third cycle of the Medicare drug price negotiation program?
Table of Contents
- 1. What drugs are included in the third cycle of the Medicare drug price negotiation program?
- 2. CMS Announces 15 Drugs for Third Cycle of Medicare drug Price Negotiation Program
- 3. Which Drugs Are Included in the Third Negotiation Cycle?
- 4. How the Negotiation Process Works
- 5. Impact on Medicare Beneficiaries
- 6. Past Context & Previous Negotiation Cycles
- 7. Challenges and Potential Concerns
CMS Announces 15 Drugs for Third Cycle of Medicare drug Price Negotiation Program
The Centers for Medicare & Medicaid Services (CMS) recently unveiled the list of 15 prescription drugs selected for the third cycle of the Medicare Drug Price Negotiation Program. This initiative, a key component of the Inflation Reduction Act, aims too lower prescription drug costs for millions of Medicare beneficiaries. This round focuses on drugs administered under Part D, the Medicare outpatient prescription drug benefit, and will see negotiated prices take effect in 2028.
Which Drugs Are Included in the Third Negotiation Cycle?
The selected drugs treat a range of conditions, including diabetes, heart failure, arthritis, and blood cancers. Hear’s a breakdown of the 15 drugs chosen for negotiation:
* Amjevita (adalimumab-atto): Used to treat autoimmune disorders like rheumatoid arthritis.
* Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide): A crucial medication for HIV treatment.
* Breztri Aerosphere (fluticasone furoate/ofumeletinib/vilanterol): Used for managing chronic obstructive pulmonary disease (COPD).
* Eliquis (apixaban): An anticoagulant used to prevent blood clots and reduce stroke risk.
* Entresto (sacubitril/valsartan): A vital treatment for heart failure.
* Fiasp/NovoLog FlexPen (insulin aspart): Rapid-acting insulin for diabetes management.
* Imbruvica (ibrutinib): Used in the treatment of certain blood cancers.
* Januvia (sitagliptin): An oral medication for type 2 diabetes.
* Jardiance (empagliflozin): Another crucial drug for managing type 2 diabetes and heart failure.
* Lynparza (olaparib): Used in the treatment of ovarian, breast, and prostate cancers.
* Ozempic (semaglutide): A GLP-1 receptor agonist for type 2 diabetes and weight management.
* Remicade (infliximab-dyyb): Used to treat autoimmune diseases like Crohn’s disease and ulcerative colitis.
* Stelara (ustekinumab-xclm): Treats psoriasis, Crohn’s disease, and ulcerative colitis.
* Xarelto (rivaroxaban): Another anticoagulant used to prevent and treat blood clots.
* Zolair (omalizumab-dkal): Used to treat chronic hives and asthma.
How the Negotiation Process Works
The negotiation process is structured and involves several key stages:
- Data Collection: CMS gathers extensive data on the selected drugs, including manufacturing costs, research and growth expenses, and sales information.
- Initial Offers: Drug manufacturers submit thier initial offers for a maximum fair price.
- Negotiations: CMS and the manufacturers engage in negotiations, with CMS aiming to secure the lowest possible price while ensuring continued drug access and innovation.
- Final Price Determination: CMS announces the final negotiated prices, which will go into effect on January 1, 2028.
Manufacturers can withdraw from the negotiation process, but doing so would result in an excise tax on sales of the drug and potentially limit Medicare coverage.
Impact on Medicare Beneficiaries
The Medicare Drug price Negotiation Program is projected to significantly lower out-of-pocket costs for beneficiaries.For the drugs selected in the first cycle (negotiated in 2023), CMS estimates savings of up to $39 billion over the next decade. The inclusion of Part D drugs in this third cycle expands the potential for savings to a wider range of Medicare enrollees.
Specifically, beneficiaries will likely see:
* Lower premiums: Reduced drug costs can translate to lower monthly premiums for Medicare Part D plans.
* Reduced cost-sharing: Copays and coinsurance for negotiated drugs may decrease.
* Improved access: Lower prices could improve access to essential medications for those with limited incomes.
Past Context & Previous Negotiation Cycles
The Inflation Reduction Act, signed into law in 2022, authorized Medicare to negotiate prices for certain high-expenditure drugs. The first cycle,announced in 2023,focused on drugs administered under Medicare Part B (physician-administered drugs). The second cycle, announced in 2024, expanded the list to include additional Part B drugs. This third cycle marks a significant expansion of the program to include Part D drugs, representing a major step towards lowering prescription drug costs for seniors and people with disabilities.
Challenges and Potential Concerns
While the program is widely supported, some challenges and concerns remain:
* Manufacturer Lawsuits: Several pharmaceutical companies
