Medicare Lists First 10 Drugs for Talks On Lowering Your Costs

The Centers for Medicare & Medicaid Services (CMS) has selected the first 10 drugs for discussions with pharmaceutical companies about reducing prescription costs under the new Medicare price negotiation program.

The 10 drugs, covered under Medicare Part D, are: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara and Fiasp/NovoLog. They accounted for $50.5 billion in total Part D covered prescription drug costs from June 2022 to May 2023, CMS said.

The talks are set to take place later this year and in 2024, with the negotiated prices taking effect in 2026. The deadline for drugmakers to sign agreements to participate in the program is Oct. 1, 2023, according to CMS, which also provided a schedule of the remaining stages of the negotiation process.

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Seniors paid $3.4 billion in out-of-pocket expenses for the 10 drugs in 2022, according to a White House fact sheet on the negotiations. One silver lining concerning Medicare coverage is that it has gained the attention of Congress. One recent bill, for example, would expand Medicare coverage for telehealth services by making COVID-era telehealth flexibility permanent, Kiplinger recently reported. The Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act (or the CONNECT for Health Act) has 59 bipartisan cosponsors, as reported.

CMS wants to hear from patients

At CMS, as part of the Medicare price negotiation program, virtual listening sessions are planned for each of the selected drugs for patients and others to participate in. The first session, on Eliquis, is set for Oct. 30, with other sessions to follow through Nov.15.

“Today marks a significant and historic moment for the Medicare program with the announcement of the first drugs selected for Medicare drug price negotiation,” Chiquita Brooks-LaSure, CMS administrator, said in a statement. “Our goal with these negotiations is to improve access to some of the costliest drugs for millions of people with Medicare while driving competition and innovation.”  

The Inflation Reduction Act that was signed into law last year allows Medicare to directly negotiate prices of certain high-expenditure, single-source drugs without generic or biosimilar competition.

"Today is the start of a new deal for patients, where Big Pharma doesn't just get a blank check at your expense and the expense of the American people,” Biden said in a speech following the CMS announcement.

The news follows CMS’s disclosure of a data breach last month that exposed the personal information of 612,000 Medicare recipients and millions of other health care consumers, as Kiplinger previously reported. The agency is notifying beneficiaries about the incident and offering free credit monitoring services, as reported. 

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