On August 15, 2024, the Biden-Harris administration announced the pricing schedule for the first ten drugs selected as part of the Medicare pricing negotiations between the U.S. Department of Health and Human Services (HHS) and drug manufacturers.
“Americans are paying too much for their prescription drugs. That makes today’s announcement historic. For the first time ever, Medicare has negotiated directly with pharmaceutical companies, and the American people are benefiting,” said HHS Secretary Xavier Becerra.
The announcement of the proposed prices for these drugs under the Inflation Reduction Act came nearly a year after the Centers for Medicare and Medicaid Services (CMS) announced the list of the first 10 drugs included in the negotiations. The list, which consists of the 10 drugs with the highest gross annual expenditures, accounts for $50.5 billion in gross prescription costs per year covered by Part D and more than $3.4 billion in out-of-pocket costs.
Among the top 10 agents selected, 4 have specific indications for patient populations with diabetes: empagliflozin, sitagliptin, dapagliflozin, and Novo Nordisk-specific insulin aspart products. According to CMS statistics, these 4 agents accounted for a total of more than $16 billion in Part D spending from June 1, 2022, to May 31, 2023.
These prices will take effect on January 1, 2026. Under the Inflation Reduction Act, CMS will select up to 15 additional drugs covered by Part D for negotiation in 2027, up to 15 additional drugs, including drugs covered by Part B and Part D, in 2028, and up to 20 additional drugs for each year thereafter.
As a continuation of their reaction episode earlier this year, this episode of Diabetes Dialogue: Technology, Therapy and Practical Perspectives examines the price changes and what they might mean for people with diabetes or members of the care team. In the episode, the presenters discuss how people with diabetes will benefit from significant price reductions on SGLT2 inhibitors and insulin products, but note that the absence of long-acting insulins and GLP-1 agonists from the initial list is notable and further negotiations will be required.
Relevant disclosures for Dr. Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Dr. Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.
Sources:
- ASPA Press Office. Negotiations for lower drug prices are working, saving billions. HHS.gov. August 15, 2024. Accessed August 19, 2024. https://www.hhs.gov/about/news/2024/08/15/historic-first-biden-harris-administration-successfully-negotiates-medicare-drug-prices-delivers-promise-lower-prescription-drug-costs-american-seniors.html.
- Fact Sheet: Biden-Harris Administration Announces New, Lower Prices for First Ten Drugs Selected for Medicare Price Negotiation to Lower Costs for Millions of Americans. The White House. August 15, 2024. Accessed August 19, 2024. https://www.whitehouse.gov/briefing-room/statements-releases/2024/08/15/fact-sheet-biden-harris-administration-announces-new-lower-prices-for-first-ten-drugs-selected-for-medicare-price-negotiation-to-lower-costs-for-millions-of-americans/.
