WASHINGTON – The Trump administration on Tuesday released the next 15 drugs subject to Medicare price negotiation, a move that for the first time includes treatments administered in doctor offices. This expansion could significantly lower costs for millions of Americans, but its impact is unfolding against a backdrop of political maneuvering.
medicare Drug Price Negotiations Expand to Doctor-Administered Treatments
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The latest round of price negotiations, set to take effect in 2028, marks a significant shift in Medicare’s approach to drug costs.
What drugs will have negotiated prices under the new Medicare plan? Fifteen drugs have been selected for price negotiation, including those for conditions like HIV, cancer, and autoimmune diseases. The negotiated prices will begin to take effect in 2028.
- This is the third round of drugs selected for Medicare price negotiation.
- For the first time, drugs administered in doctor’s offices (Part B) are included.
- The negotiated prices won’t be available to patients until 2028.
- The Trump administration has emphasized voluntary agreements with drugmakers alongside
Medicare has thorough claims data for retail drugs, but obtaining detailed pricing information for Part B drugs is more complex, particularly within Medicare Advantage plans, which cover over half of Medicare beneficiaries. While Medicare tracks utilization of Part B drugs, precise pricing data remains elusive.
Six of the selected drugs are frequently administered in doctor’s offices, though some are also available for self-administration under Part D.
Drugs Selected for Medicare Price Negotiation
- anoro Ellipta, chronic obstructive pulmonary disease. (GlaxoSmithKline)
- biktarvy, HIV. (Gilead sciences)
- Botox and Botox Cosmetic, several cosmetic and therapeutic uses, including chronic migraines. (AbbVie)
- Cimzia, rheumatoid arthritis, Crohn’s disease, and other autoimmune conditions. (UCB)
- Cosentyx, autoimmune conditions including plaque psoriasis. (Novartis)
- Entyvio,active ulcerative colitis and Crohn’s disease. (Takeda)
- Erleada, prostate cancer. (Janssen Biotech)
- Kisqali, breast cancer. (Novartis)
- Lenvima, advanced cancers.(Eisai)
- Orencia, rheumatoid arthritis and psoriatic arthritis. (Bristol-Myers Squibb)
- Rexulti, schizophrenia. (Otsuka Pharmaceuticals)
- Trulicity, cardiovascular diseases. (Eli Lilly)
- Verzenio, breast cancer.(Eli Lilly)
- Xeljanz and Xeljanz XR,rheumatoid arthritis and multiple other inflammatory conditions. (Pfizer)
- xolair,asthma and other allergic reactions. (Genentech)
