Biden Targets Cancer, Diabetes Drugs In Controversial Medicare Price Battle

The Centers for Medicare and Medicaid Services unveiled the first ten drugs subject to price negotiations under President Joe Biden's Inflation Reduction Act, including:

• Bristol Myers Squibb Co's BMY blood thinner, Eliquis
• Eli Lilly And Co's LLY diabetes treatment, Jardiance.
• Johnson & Johnson's JNJ Xarelto (blood thinner), Stelara (psoriasis, arthritis, ulcerative colitis, Crohn's disease), Imbruvica (blood cancer).
• Merck & Co Inc's MRK blood pressure drug, Januvia.
• AstraZeneca Plc's AZN Farxiga (chronic kidney disease, heart failure, type 2 diabetes).
• Novartis AG's NVS heart failure drug Entresto.
• Amgen Inc's AMGN arthritis medicine Enbrel.
• Novo Nordisk A/S's NVO insulin analog, Fiasp.

These selected drugs accounted for $50.5 billion in total Part D gross covered prescription drug costs, or about 20% of total covered prescription drug costs between June 1, 2022, and May 31, 2023.

The negotiated prices for the ten therapies will take effect on January 1, 2026, according to revised guidance published by CMS.

In the future, CMS will select for negotiation up to 15 more drugs covered under Part D for 2027, up to 15 more drugs for 2028, and up to 20 more drugs for each year after that, as outlined in the Inflation Reduction Act.

AstraZeneca became the latest to challenge the U.S. government's Inflation Reduction Act legally.

October 2 is the deadline for companies of drugs selected for the Negotiation Program to submit manufacturer-specific data to CMS to consider in negotiating a maximum fair price.

Medicare enrollees taking the ten drugs covered under Part D selected for negotiation paid $3.4 billion in out-of-pocket costs in 2022 for these drugs.

CMS has until February 1, 2024, to send initial offers of a maximum fair price, with a justification, for each selected drug to each company on the list.

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