| WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services (CMS) has unveiled the next 15 high-priced medications subject to Medicare negotiation. Building on the 2024 milestone, when prices were successfully negotiated for the first 10 drugs under the 2022 prescription drug law, this expansion marks another major step toward ensuring seniors and people with disabilities can access the medications they need at prices they can afford.
These newly selected drugs, used by 5.3 million people on Medicare, to treat conditions ranging from cancer and type 2 diabetes to asthma, have experienced substantial price increases since market entry. For example, the price of the type 2 diabetes and cardiovascular medication Ozempic has risen by 30% over seven years, while the drug Xifaxan, which is used to treat irritable bowel syndrome, has gone up by 72% since it was introduced in 2004. In January of this year alone, 12 of 15 drugs on the list saw prices increased by their manufacturers, 11 of which were higher than the rate of inflation. These surging price hikes underscore the urgency of Medicare’s negotiation program to ensure patients can better afford their medications without sacrificing other life essentials.
Merith Basey, Executive Director of Patients For Affordable Drugs, issued the following statement:
“For the last twenty years, drug corporations have rigged the system in their favor – hiking prices at will and leaving millions of patients at their mercy. Thanks to the 2022 prescription drug law, last year Medicare negotiated a better deal on 10 of some of the most expensive and most commonly used drugs covered by the program, breaking the decades-long prohibition, which will lower prices for nine million patients starting next year. Today’s announcement of 15 additional high-cost drugs builds on that historic progress and will lower costs for millions more patients in 2027.
“But let’s be clear: we must keep pushing to expand the wildly popular Medicare negotiation program. Patients fought extremely hard for the passage of these reforms and they continue to vigorously defend them against pharma’s attacks – because nobody should have to choose between life-saving drugs and their basic needs.”
The 15 drugs included in the next round of negotiations are:
Lower negotiated prices on these drugs will bring meaningful relief to patients all across the country including:
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Carole from Flint, Michigan, who depends on Ofev, a medication that costs $14,000 for 60 pills, to extend her life. The drug won’t cure her lung disease, but it will give Carole a few more years to live.
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Mary of Lafayette, California, who saw her copay for Pomalyst – the drug she depends on to stay in remission from multiple myeloma – soar from $585 for 14 pills in 2019 to $943 in 2020 after transitioning to Medicare.
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Teresa from North Carolina whose heart condition means Breo Ellipta is the only inhaler that she can use to manage her asthma but with a price of over $400, she can’t afford it.
Medicare Negotiation By The Numbers
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The historic 2022 prescription drug law requires negotiation for up to 60 drugs by 2029, which is monumental given that, for more than two decades, Medicare was barred from negotiating.
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$100 billion: Taxpayer savings specifically from Medicare negotiation through 2031.
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$6 billion: Estimated Medicare savings if lower negotiated prices on the first 10 selected drugs had been in effect in 2023.
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$1.5 billion annually: Estimated out-of-pocket savings for people on Medicare Part D on the first 10 selected drugs starting in 2026.
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656,967 fewer deaths: Projected over seven years due to improved treatment adherence, with nearly 94,000 lives saved annually from reduced out-of-pocket costs from Medicare negotiation.
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$237 billion: Projected total taxpayer savings from the 2022 prescription drug law through 2031.
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These 15 selected medications alone accounted for roughly $41 billion in total gross covered prescription drug costs under Medicare Part D—14 percent of the program’s entire spending during that period.
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