The next 15 drugs up for negotiation with Medicare include several blockbusters

By now, everyone is quite familiar with the drug price negotiations taking place between drug companies and the Centres for Medicare & Medicaid Services (CMS) in the USA as part of measures being taken to reduce the cost of drugs for patients, to make them more accessible. 

Now, the next 15 drugs to undergo negotiations have been announced by the CMS. The drug companies making these drugs will enter into negotiations with the CMS throughout 2025, with the agreed prices then coming into effect in 2027. 

The drugs cover a variety of conditions, from cancer to type 2 diabetes, and asthma. They accounted for 14% of the total gross covered prescription drug costs under Medicare Part D from November 2023 to October 2024. 

HHS Secretary Xavier Becerra commented: 

“Last year we proved that negotiating for lower drug prices works. Now we plan to build on that record by negotiating for lower prices for 15 additional important drugs for seniors… the Inflation Reduction Act is lowering prices for people on Medicare. HHS will continue negotiating in the best interest of people with Medicare to have access to innovative, life-saving treatments at lower costs.” HHS Secretary Xavier Becerra.

1.    Ozempic, Rybelsus and Wegovy (Novo Nordisk) – A once-weekly injectable medication for type 2 diabetes, also used off-label for weight loss, the first oral GLP-1 receptor agonist for type 2 diabetes, helping to lower blood sugar and a higher-dose version of semaglutide, FDA-approved for chronic weight management, respectively.
2.    Trelegy Ellipta (GSK – GlaxoSmithKline) – A once-daily inhaler that combines three medications to treat COPD and asthma.
3.    Xtandi (Astellas & Pfizer) – An oral medication for metastatic prostate cancer, working as an androgen receptor inhibitor.
4.    Pomalyst (Bristol Myers Squibb) – A treatment for multiple myeloma, used in patients who have received prior therapies.
5.    Ibrance (Pfizer) – A targeted therapy for HR-positive, HER2-negative breast cancer, taken orally as a CDK4/6 inhibitor.
6.    Ofev (Boehringer Ingelheim) – A medication for idiopathic pulmonary fibrosis (IPF) and certain chronic lung diseases, reducing lung function decline.
7.    Linzess (AbbVie & Ironwood Pharmaceuticals) – A medication for chronic constipation and irritable bowel syndrome with constipation (IBS-C).
8.    Calquence (AstraZeneca) – A BTK inhibitor used to treat chronic lymphocytic leukaemia (CLL) and mantle cell lymphoma (MCL).
9.    Austedo; Austedo XR (Teva Pharmaceuticals) – A treatment for tardive dyskinesia and Huntington’s disease-related chorea.
10.    Breo Ellipta (GSK – GlaxoSmithKline) – A combination inhaler used for COPD and asthma, containing fluticasone and vilanterol.
11.    Tradjenta (Boehringer Ingelheim & Eli Lilly) – An oral DPP-4 inhibitor for type 2 diabetes, helping to lower blood sugar.
12.    Xifaxan (Bausch Health) – An antibiotic mainly used to treat traveller’s diarrhoea and irritable bowel syndrome with diarrhoea (IBS-D).
13.    Vraylar (AbbVie & Gedeon Richter) – An antipsychotic for schizophrenia, bipolar disorder and major depressive disorder (as an adjunct therapy).
14.    Janumet; Janumet XR (Merck & Co.) – A combination of sitagliptin and metformin for type 2 diabetes to improve blood sugar control.
15.    Otezla (Amgen) – A PDE4 inhibitor for treating psoriasis, psoriatic arthritis, and oral ulcers in Behçet’s disease.

Again this selection targets some of the most high profile drugs and drug makers in the industry, and will no doubt lead to complex negotiations, but this time at least, the companies know more what to expect. 

CEO of Novo Nordisk Lars Jørgensen stated: 

"I would say, as expected, because of its success in the market, Wegovy and Ozempic and Rybelsus were included in the next round of IRA negotiations. We have some experience in the first round of negotiations where some of our insulins were included and we feel comfortable in our ability to manage this.” 

In the future, the CMS will select up to an additional 15 drugs for the third cycle of negotiation, and up to 20 more drugs for each subsequent cycle, as originally outlined in the Inflation Reduction Act.