Employee Benefit News for School, City and County Employers

First Medicare Drug Price Negotiations Announced

Written by Steve Smith | Sep 3, 2024 7:36:02 PM

1.5 minute read

On August 15, the Department of Health and Human Services (HHS) and top drugmakers agreed to lower prices on the first 10 drugs subject to Medicare price negotiations. Drug discounts range between 38-79%. The new pricing for Medicare Part D enrollees starts January 1, 2026.

The Inflation Reduction Act enables direct government negotiations with drug manufacturers to improve access to costly brand-name drugs under the Medicare Drug Price Negotiation Program. The following Medicare Part D drugs will be the first ones subject to these negotiations:

  • Eliquis, for preventing and treating blood clots
  • Jardiance, for treating diabetes and heart failure
  • Xarelto, for preventing and treating blood clots; also reduces risks for patients with coronary or peripheral artery disease
  • Januvia, for treating diabetes
  • Farxiga, for treating health failure, diabetes, and chronic kidney disease
  • Entresto, for treating heart failure
  • Enbrel, for threating rheumatoid arthritis, psoriasis, and psoriatic arthritis
  • Imbruvica, for treating blood cancers
  • Stelara, for treating psoriasis, and psoriatic arthritis Crohn’s disease, and ulcerative colitis
  • Fiasp/NovoLog, for treating diabetes

Medicare Part D enrollees may struggle to access life-saving medications like those for diabetes and heart failure due to costs. The HHS estimates $1.5 billion in savings on out-of-pocket costs for Medicare prescription drug coverage in 2026.

 

What’s Next?

The Medicare Drug Price Negotiation Program aims to reduce out-of-pocket costs for seniors and save taxpayers money. The new pricing is effective January 1, 2026 and Medicare will negotiate up to 15 additional drugs under Part D by February 1, 2025, and will continue to select more drugs annually. Employers should continue to monitor healthcare trends and costs. Download the bulletin for more details.