It’s taken a year for President Biden’s lower-cost prescription drug law, included in the Inflation Reduction Act, to find its way toward becoming official, but that day has come.
The Centers for Medicare and Medicaid Services (CMS) has announced that Medicare is now able to directly negotiate the prices of prescription drugs, positively impacting the finances of millions of Americans.
The first 10 drugs covered under Medicare Part D selected for negotiation under the Medicare Drug Price Negotiation Program include:
Eliquis (Prevention and treatment of blood clots)
Jardiance (Diabetes; Heart failure)
Xarelto (Prevention and treatment of blood clots; Reduction of risk for patients with coronary or peripheral artery disease)
Januvia (Diabetes)
Farxiga (Diabetes; Heart failure; Chronic kidney disease)
Entresto (Heart failure)
Enbrel (Rheumatoid arthritis; Psoriasis; Psoriatic arthritis)
Imbruvica (Blood cancers)
Stelara (Psoriasis; Psoriatic arthritis; Crohn’s disease; Ulcerative colitis)
Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill (Diabetes)
A promise of transparency
“Transparency” gets ballyhooed a lot in the consumer world, but CMS brass is going on record that it’s serious when it uses that word.
“Promoting transparency and engagement continue to be at the core of how we are implementing the new drug law and the Medicare Drug Price Negotiation Program, and that is why we set out a process for the first round of negotiation that engages the public throughout,” said Dr. Meena Seshamani, deputy administrator and director of the Center for Medicare.
Hold your horses
Don’t head down to the drugstore asking for a price break, yet. CMS says the manufacturers of these drugs first have to agree to the process. Those companies have until October 1 to sign off on that and then will have until September 2024 to make that commitment real.
At that point, CMS will publish the "maximum fair prices” for those 10 drugs, but it will be another two years – 2026 – until the negotiated prices for those drugs go into effect.
However, there may be a short-term option. With CVS Caremark offering lower prescription costs with its new Cost Saver program and Kroger doing a deal with Mark Cuban's CostPlus Drugs, it's possible that those 10 drugs destined for price decreases might become available at a better price point sooner than 2026.