The Centers for Medicare and Medicaid Services announced Tuesday that they will lower the prices of 15 prescription drugs offered through Medicare, the health insurance system for people over 65 or with a disability.
The drugs set to drop in price include Ozempic and Wegovy, semaglutide medications, originally used for people with diabetes or insulin resistance but which many more people have started taking given their widespread benefits against other medical consequences of obesity, such as cardiovascular problems.
The announcement is the result of negotiations initiated by the Government of Joe Biden (2020-2024) to reduce the prices of these medicines through the Inflation Reduction Act that the Democrat signed in 2022.
(Many drop coverage after premiums increase under Obamacare after Congress did not renew subsidies)
The current Government, led by Republican Donald Trump, has also sought to get the manufacturer of Ozempic and Wegovy, the Danish company Novo Nordisk, to reduce the prices of these drugs. However, so far it has done so through voluntary decrees and agreements, with Trump promising to reduce his tariffs in return; In contrast, this week’s cost cutting was done through mandatory legislation.
Earlier this year, the Trump Administration had indicated that it did not support the inclusion of Ozempic in Medicare, but then began to manage the price reduction voluntarily.
The new prices will be those paid by Medicare to distribute drugs like Wegovy to beneficiaries of the program, and not those that will be accessible to all patients in general who have other health insurance.
However, the price adjustment could lead to up to $12 billion in savings for U.S. taxpayers, according to the Center for Medicaid and Medicare, while Medicare beneficiaries could pay up to $685 million less overall with the purchase. out of pocket of these drugs.
(AstraZeneca agrees to reduce prices for Medicaid purchases as Trump Administration promises to cut tariffs)
During the Biden Administration, it was also possible to negotiate lower prices for 10 other prescription drugs; these cost reductions will come into effect starting in 2026. The 15 drugs announced this Tuesday will have lower prices starting in 2027.
Trump’s Secretary of Health and Human Services, led by Robert F. Kennedy Jr., celebrated the announcement regarding the drugs that resulted from the Biden Administration’s negotiations.
“As we work to Make America Healthy Again, we will use every tool at our disposal to make health care affordable for older adults,” Kennedy Jr. said in a statement.
Pharmaceutical companies can refuse to enter into negotiations like those carried out by the Biden Administration, but doing so could lead to their drugs no longer being available in Medicare, which is one of the largest markets in the United States.
These are the new prices for the 15 drugs announced this Tuesday, compared to the average prices on the market in force in 2024:
- Ozempic, Rybelus and Wegovy for people with type 2 diabetes and who need to lose weight in a controlled and doctor-reviewed manner: the purchase price in Medicare will be $274 compared to the general cost to the consumer, which is around $960.
- Trelegy Ellipta, an asthma treatment: will cost $175 instead of $654.
- Xtandi for people with prostate cancer: $7,004 instead of $13,480.
- Chemotherapy drug Pomalyst will cost about $8,650 instead of $21,744.
- The cost of Ofev, for the chronic disease idiopathic pulmonary fibrosis, will go from $12,622 to $6,350.
- Breast cancer drug Ibrance will drop to $7,871 compared to the current price of about $15,741.
- Linzess, for people who suffer from chronic constipation, will now cost about $136 instead of $539.
- The cancer treatment drug Calquence will drop from $14,228 to $8,600.
- Medications for patients with Huntington’s disorder, Austedo and Austedo XR, will go from approximately $6,000 to approximately $4,093.
- Breo Ellipta, to treat chronic obstructive pulmonary disease (COPD), will drop from $397 to about $67.
- The irritable bowel syndrome drug Xifaxan will drop to $1,000 from $2,696.
- The antipsychotic drug Vraylar will be $770 instead of $1,376.
- The diabetes drug Tradjenta will cost about $78, down from the current average cost of $488.
- Other diabetes drugs, Janumet and Janumet XR, will also drop from $526 to about $80.
- Otezla, for those with psoriatic arthritis inflammation, will cost Medicare $1,650 instead of $4,722.
In total, these 15 drugs cost about $42.5 billion in 2024 Medicare Type D spending; That represents 15% of that item.
Type D expenses are for drugs that Medicare helps provide for patients who will take their medications at home instead of those administered in clinics, such as intravenous chemotherapy.
“I think these are very good price negotiations,” said Stace Dusetzina, a public health professor at Vanderbilt University in Tennessee. “Hopefully it will give some relief to both (Medicare) beneficiaries and taxpayers in the long run.”
According to surveys, one in five adults in the United States has stopped filling prescriptions because they consider the medications they need to be too expensive, according to data from the Kaiser Family Foundation group. And one in seven have said they have tried to skip doses or take only half a pill to make already filled prescriptions last longer.
