Some asthma and COPD drugs are likely included in first year of price negotiations. Article and excerpts follow.
Excerpts from Pharma Fierce news on which drugs are likely to be included in the new Medicare price negotiations (some drug input from NY Times).
https://www.fiercepharma.com/pharma/pfizer-bmss-eliquis-tops-list-drugs-destined-medicare-negotiations-2026-moodys
In September of this year, CMS will identify the 10 drugs that will be affected in 2026 for price negotiation. The list will be based on Medicare spending for the period starting in June of last year and ending in May of this year.
NOTE: Eliquis is the costliest drug to Medicare. In 2021, CMS paid more than twice as much - $12.6 billion excluding discounts- to supply the blood thinner to seniors as it did for any other medicine.
Under the Inflation Reduction Act of 2022, the government will select an initial set of 10 drugs for price negotiations based on how much the Part D program spends on them. (Part B drugs are affected starting 2028). More drugs would be added in the coming years. In 2026, 10 Part D drugs will become subject to negotiated prices. Each year after that, more medicines will be added to the negotiation list, escalating quickly to include 80 by 2030. In the first year, the maximum negotiated price will range from 40% to 75% of the 2021 average price of the drug.
Drugs in this article as possibly on the list for price negotiations are: (blood thinners) Eliquis, Xarelto. (cancer) Imbruvica, Keytruda, Opdivo, Xtandi. Ozempic. (asthma or chronic obstructive disorder) Symbicort, Trelegy. (bladder) Myrbetriq. (rheumatoid arthritis and autoimmune disorders) Enbrel, (diabetes) Jardiance, Trulicity.
Not on the list may be drugs that will lose patent protection or have a similar bio-similar drug available such as (macular degeneration) Eylea.
In 2024, costs in the Medicare catastrophic phase will change: the 5% coinsurance requirement for Part D enrollees will be eliminated and Part D plans will pay 20% of total drug costs in this phase instead of 15%. This would affect the cost for drugs like Imbruvica, Revlimid and Ibrance. The average Part D spending per beneficiary in 2021 for each of these drugs was more than $100,000.
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