Medicare Drug Prices: This year, Medicare participants will be able to learn how much the prices of certain drugs will decrease as part of government plans to improve access to and lower the cost of medication.
Individuals aged 65 and older, as well as certain individuals under 65 with disabilities or health conditions, can receive health insurance through Medicare. Part D of Medicare provides coverage for prescription drugs and vaccines as well.
It has been granted to the Centers for Medicare & Medicaid Services (CMS) the right to negotiate the prices of selected drugs directly with manufacturers under President Joe Biden’s Inflation Reduction Act. CMS has selected 10 drugs to treat a variety of illnesses and conditions.
According to the White House release, Medicare spending on these 10 drugs more than doubled between 2018 and 2022—three times faster than all Part D drugs. Federal agencies or federal inventions developed seven out of ten drugs.
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Nevertheless, drug companies that have products that are up for negotiation have filed lawsuits against the Biden administration’s plans. All of the companies are suing to halt the negotiation process, including Merck, Johnson & Johnson, Bristol Myers Squibb, AstraZeneca, Novo Nordisk, Novartis, and Boehringer Ingelheim.
According to drug manufacturers, the CMS plans violate the Fifth Amendment, which requires the state to compensate for any private property taken for public use. Newsweek has contacted the CMS for a response.
Can we expect a decrease in drug prices in 2024?
Drug prices won’t decline in 2024 due to the Inflation Reduction Act, but future changes are possible.
To participate in the CMS negotiation program, CMS will send its maximum fair price, along with a justification, to each company participating in the program. Companies will have 30 days to accept or counteroffer this offer.
However, Medicare drug prices will not be reduced due to current negotiations until 2026 because the process is lengthy. CMS will publish any changes in prices on September 1, 2024, and will implement them on January 1, 2026.
Medicare Part B will cover more specialized medications as the process advances. In 2027, 15 drugs were negotiated, and in 2028, another 15 were negotiated.
From 2029 onwards, experts expect the number of medications to increase to 20 per year.
What are the drugs whose prices will change?
During the first round of negotiations, healthcare companies and the government are discussing only certain drugs. These include:
- Eliquis
- Jardiance
- Xarelto
- Januvia
- Farxiga
- Entresto
- Enbrel
- Imbruvica
- Stelara
- Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill
Medicare Part D covers prescription medications for America’s senior citizens. These drugs are among the top 50 most expensive. They cover a range of conditions, including diabetes, arthritis, Crohn’s disease, and cancer.
Negotiations and acceptance of offers will determine the precise price increase for the chosen drugs.
