Medicare broadcasts worth cuts for 15 prescribed drugs, together with Ozempic

[ad_1] The Facilities for Medicare and Medicaid Providers on Tuesday announced decrease costs on 15 costly prescription drugs beneath Medicare, together with Ozempic and Wegovy.

The worth cuts come via the Medicare drug worth negotiation program created beneath the Inflation Reduction Act , which President Joe Biden signed into regulation in 2022.

It’s completely different from President Donald Trump’s “most favored nation” drug pricing approach , which depends on govt orders and voluntary offers with drugmakers — not laws. Trump just lately introduced such a deal with Novo Nordisk , the maker of Ozempic and Wegovy, to decrease the value of the medicine in change for tariff reduction.

The Trump administration has been largely quiet in regards to the Medicare worth negotiation program.

That is the second spherical of negotiations. Final yr, the Biden administration reached deals on 10 prescription drugs , together with a number of for coronary heart illness and diabetes. These worth cuts are set to take impact in 2026. This newest spherical of worth negotiations will go into impact in 2027.

“President Trump directed us to cease at nothing to decrease well being care prices for the American individuals,” Well being and Human Providers Secretary Robert F. Kennedy Jr. said in a news release . “As we work to Make America Wholesome Once more, we'll use each device at our disposal to ship reasonably priced well being care to seniors.”

Drugmakers can select to not strike offers beneath the negotiation program, however doing so would most certainly imply withdrawing their medicine from Medicare — slicing them off from one of many nation’s largest markets. Drugmakers have challenged this system in courtroom however to this point have been unsuccessful.

The negotiated costs are what Medicare can pay drugmakers for the medicines, not what sufferers can pay out of pocket. These reductions will save taxpayers $12 billion, in keeping with CMS. It’s anticipated to save lots of Medicare enrollees $685 million in out-of-pocket prices in 2027.

Here are the negotiated prices for the drugs , based mostly on a 30-day provide, in comparison with the 2024 record worth:

Ozempic, Rybelsus and Wegovy, for Kind 2 diabetes and weight reduction: $274 negotiated worth, down from the $959 record worth. (Negotiated costs for increased doses of Wegovy are $385.) Trelegy Ellipta, an bronchial asthma therapy: $175, down from $654. Xtandi, for prostate most cancers: $7,004, down from $13,480. Pomalyst, a chemotherapy drug: $8,650, down from $21,744. Ofev, for idiopathic pulmonary fibrosis: $6,350, down from $12,622. Ibrance, a breast most cancers drug: $7,871, down from $15,741. Linzess, a continual constipation drug: $136, down from $539. Calquence, a most cancers drug: $8,600, down from $14,228. Austedo and Austedo XR, for Huntington’s illness: $4,093, down from $6,623. Breo Ellipta, a COPD drug: $67, down from $397. Xifaxan, for diarrhea and irritable bowel syndrome: $1,000, down from $2,696. Vraylar, an antipsychotic drug: $770, down from $1,376. Tradjenta, a diabetes drug: $78, down from $488. Janumet and Janumet XR, diabetes medicine: $80, down from $526. Otezla, a psoriatic arthritis drug: $1,650, down from $4,722. The 15 medicine accounted for $42.5 billion, or 15%, of complete Medicare Half D spending in 2024. Medicare Half D covers drugs that individuals take at dwelling, versus these administered in a facility, equivalent to IV chemotherapy.

“The worth negotiations look very affordable to me,” stated Stacie Dusetzina, a well being coverage professor at Vanderbilt College in Nashville, Tennessee. “It ought to hopefully present some reduction for taxpayers and beneficiaries in the long term.”

Dusetzina stated the $274 negotiated worth for Ozempic and Wegovy is increased than the $250 worth in Trump’s deal. “They need to’ve gotten that deal for the taxpayers and the Medicare beneficiaries,” she stated.

The worth cuts come as many Individuals say the price of prescribed drugs is unaffordable.

About 1 in 5 adults say they’ve skipped filling a prescription as a result of it was too costly, in keeping with a survey published in July by health policy research group KFF . About 1 in 7 say they've minimize tablets in half or skipped doses of drugs within the final yr due to the price.