Medicare Can Now Negotiate Ten Drugs To Help Seniors Save Money

For far too long, Americans have paid more for prescriptions drugs than any major economy. But now, thanks to the Inflation Reduction Act, Medicare can directly negotiate prescription drug prices to get a better deal for seniors. Today, Medicare has for the first time selected 10 drugs for negotiation.  Seniors paid $3.4 billion in out-of-pocket costs for these drugs in 2022.

Big Pharma has long fought this progress. Their profits grew as they spent more on stock buybacks and dividends than they spent on research and development, even as nearly three in ten Americans struggle to afford their medications because of cost.

On Monday, the Biden-Harris Administration announced the significant milestone in implementing lower health care and prescription drug costs and ushering in a new era for American seniors. Over the next 4 years, Medicare will negotiate prices for up to 60 drugs covered under Medicare Part D and Part B, and up to an additional 20 drugs every year after that.

HHS Announces First Set of Drugs Selected for Medicare Price Negotiation

For the first time ever, HHS announced ten drugs selected for Medicare drug price negotiation:

Drug Name Commonly Treated Conditions Total Part D Gross Covered Prescription Drug Costs from June 2022-May 2023 Number of Medicare Part D Enrollees Who Used the Drug from June 2022-May 2023 Average Part D Covered Prescription Drug Costs Per Enrollee
Eliquis Prevention and treatment of blood clots $16,482,621,000 3,706,000 $4,448
Jardiance Diabetes; Heart failure $7,057,707,000 1,573,000 $4,487
Xarelto Prevention and treatment of blood clots; Reduction of risk for patients with coronary or peripheral artery disease $6,031,393,000 1,337,000 $4,511
Januvia Diabetes $4,087,081,000 869,000 $4,703
Farxiga Diabetes; Heart failure; Chronic kidney disease $3,268,329,000 799,000 $4,091
Entresto Heart failure $2,884,877,000 587,000 $4,915
Enbrel Rheumatoid arthritis; Psoriasis; Psoriatic arthritis $2,791,105,000 48,000 $58,148
Imbruvica Blood cancers $2,663,560,000 20,000 $133,178
Stelara Psoriasis; Psoriatic arthritis; Crohn’s disease; Ulcerative colitis $2,638,929,000 22,000 $119,951
Fiasp; Fiasp FlexTouch; Fiasp PenFill;
NovoLog; NovoLog FlexPen; NovoLog PenFill

These ten drugs are among those with highest total spending in Medicare Part D. Millions of Part D enrollees depend on these vital treatments to treat life-threatening conditions including diabetes, heart failure, and cancer, but many struggle to access their medications because of prohibitive costs.

Medicare drug price negotiation will result in lower out-of-pocket costs for seniors and will save money for American taxpayers. Negotiations for the first group of selected drugs will begin in 2023, with negotiated prices going into effect in 2026.

Out-of-Pocket Costs for Drugs Covered Under Part D Selected for Drug Price Negotiation, by State

HHS also released a report showing that 9 million Medicare Part D enrollees took the drugs covered under Part D selected for negotiation and paid a total of $3.4 billion in out-of-pocket costs for these drugs in 2022.  For enrollees without additional financial assistance, average annual out-of-pocket costs for these drugs were as high as $6,497 per enrollee in 2022.

To view a state-by-state breakdown of the number of Medicare enrollees who use the prescription drugs selected for negotiation and their out-of-pocket costs, visit HHS’s website.