Fri, 17 Jan 2025

Ozempic is in the next round of Medicare drug price negotiations. See the full list of 15 medications

The talks on drugs including Novo Nordisk's Wegovy, GSK's Trelegy Ellipta, and Pfizer's Xtandi will set Medicare prices that go into effect in 2027.
1. Second round of negotiations: The Centers for Medicare & Medicaid Services (CMS) has announced the second round of negotiations with pharmaceutical companies to lower Medicare Part D prices. 2. 15 medications selected: 15 medications have been selected for the second round, including popular medications like Ozempic (semaglutide), Trelegy Ellipta, and Xtandi. 3. Patient advocacy groups support the move: Patient advocacy groups, such as AARP, applaud the announcement, stating that it will reduce prices and create billions of dollars in savings for Medicare beneficiaries. 4. Pharmaceutical companies oppose the move: Pharmaceutical companies, including Bristol Myers Squibb, Teva Pharmaceuticals, and Boehringer Ingelheim, have expressed concerns that the price talks could hurt patient access and future innovation in the industry. 5. Participating or paying a penalty: If a pharmaceutical company decides not to participate in the negotiations, it must either pay an excise tax of up to 95% of its medication's U.S. sales or pull all of its products from the Medicare and Medicaid markets. 6. Negotiation process: The negotiation process involves months of back-and-forth price offers between CMS and pharmaceutical companies. The federal program determines its initial offer for each medication using various data points, including sales volume, development costs, and patent applications. 7. Next steps: The next round of negotiations will conclude in 2028, with an additional 15 medications selected for negotiation. In 2029, the number of negotiated medications will rise to 20 per year. Key statistics mentioned in the article include:
* Medicare Part D spent $14.43 billion on Ozempic (semaglutide), Rybelsus, and Wegovy.
* Nearly 2.3 million enrollees used those drugs between Nov. 1, 2023, and Oct. 31, 2024.
* The plan also spent roughly $5.14 billion on Trelegy Ellipta, which was used by 1.3 million enrollees.
* Xtandi cost Medicare Part D $3.16 billion despite only 35,000 enrollees using the medication. Overall, the article highlights the ongoing efforts to lower Medicare drug prices and the pharmaceutical companies' concerns about the impact of these negotiations on patient access and innovation in the industry.
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