Despite Medicare Negotiations, Americans May Still Have To Pay More For Prescription Drugs

Over the weekend, the U.S. government announced first-ever negotiated prices for prescription drugs for ten drugs covered under Medicare Part D that will go into effect beginning January 1, 2026.

The negotiated prices are expected to save an estimated $6 billion in net covered prescription drug costs.

• The price of Bristol Myers Squibb Co’s BMY blood thinner Eliquis has been negotiated to $231.
• Eli Lilly And Co’s LLY diabetes treatment, Jardiance, is priced at $197, down 66%.
• Johnson & Johnson’s JNJ Xarelto (blood thinner), Stelara (psoriasis, arthritis, ulcerative colitis, Crohn’s disease), Imbruvica (blood cancer) could be available at $197, $4,695, and $9,319, respectively people enrolled in Medicare prescription drug coverage.
• Merck & Co Inc’s MRK blood pressure drug, Januvia, is priced at $113.
• AstraZeneca Plc’s AZN Farxiga (chronic kidney disease, heart failure, type 2 diabetes) will cost $178.50.
• Novartis AG’s NVS heart failure drug Entresto’s price was cut by 53% to $295.
• Amgen Inc’s AMGN arthritis medicine Enbrel will be priced at $2,355.
• Novo Nordisk A/S’s NVO insulin analog, Fiasp, will cost $119, down 76%.

Also Read: Bristol Myers, Johnson & Johnson, AbbVie, AstraZeneca Expect Minimal Impact From Upcoming Medicare Price Negotiations.

A Reuters review found that the negotiated prices for Medicare are still more than double, and sometimes five times, what drugmakers have agreed to in countries like Sweden, Canada, Japan, and Australia.

• A 30-day supply of nine out of ten drugs will still cost Medicare $17,581 in 2026, compared to just $6,725 in Sweden today.

Experts highlight that the U.S. has long accepted its role as the highest payer for prescription drugs, viewing it as a trade-off for early access to new medicines.

Bristol Myers stated that pricing is specific to each country, based on national health systems and regulatory policies. Merck argued that comparing U.S. prices to overseas generics is invalid.

The U.S. agency overseeing Medicare stated that international prices were not considered in the negotiations, which focused instead on factors like manufacturer data and the availability of alternative treatments.

The U.S.’s willingness to pay more for drugs also drives up prices globally, as other countries benefit from lower prices due to U.S. expenditures.

The lack of generic competition in the U.S. for certain drugs further exacerbates the problem. For instance, a biosimilar to Amgen’s Enbrel, which costs Medicare $2,355 for a 30-day supply, is available in Sweden for just $709.

Disclaimer: This content was partially produced with the help of AI tools and was reviewed and published by Benzinga editors.

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