The Centers for Medicare and Medicaid Services (CMS), which oversees Medicare drug price negotiation, just released details regarding the 15 drugs with negotiated prices that will take effect in 2027. The Medicare program should save billions, which could keep down premiums, but people with Medicare who use these drugs will save substantially less, Joyce Frieden reports for MedPageToday. Moreover, the new prices for some drugs are still twice as high as Canada’s.
CMS reports that, in 2027, people taking these 15 drugs should see a total savings on Medicare Part D copays of $685 million or around 40 percent, down from $1.7 billion. CMS does not say whether the negotiated prices are as low as other wealthy countries negotiate for their citizenry. The discount for the government on these drugs is 36 percent.
The government reports that the new prices for the drugs are as much as 85 percent below their list prices. In terms of government savings, CMS reports that had the negotiated prices been in effect last year, Medicare would have saved $8.5 billion. So government savings for these negotiated drugs are significant.
CMS further reports that about 5.3 million people with Medicare use one or more of the drugs with negotiated prices through their Part D prescription drug benefit. Drugs with negotiated prices in 2027 include GLP-1’s: Ozempic, Rybelsus, Wegovy. CMS reports that 2,282,000 people with Medicare take a GLP-1 drug.
CMS reports that 1,269,000 people with Medicare take Trelegy Elipta for Chronic Obstructive Pulmonary Disease and asthma. Around 66,000 more people with Medicare take a cancer drug with a negotiated price. You can see a list of all the drugs, as well as the conditions they treat, below.
The Inflation Reduction Act of 2022, which had no Republican support, called for CMS to negotiate Medicare drug prices on 10 drugs last year and 15 drugs this year. The Trump administration fulfilled its obligation under the law, though as of yet has done very nothing to lower prices on all drugs for all Americans to a level on a par with other wealthy nations, as President Trump said he intended to do. Moreover, Republicans in Congress added delays and exemptions to future Medicare drug price negotiations for some expensive drugs, blocking $9 billion in savings, according to Public Citizen.
Lower drug prices on the first 10 drugs for people with Medicare take effect in 2026 and these next 15, in 2027. All prices below are for 30-day supplies.
- Semaglutide: used to treat type 2 diabetes, obesity/overweight, and cardiovascular disease (list price $959; negotiated price $274)
- Fluticasone furoate, umeclidinium, and vilanterol, (Trelegy Ellipta): chronic obstructive pulmonary disease (COPD) and asthma (list price $654; negotiated price $175)
- Enzalutamide (Xtandi): prostate cancer (list price $13,480 ; negotiated price $7,004) The price in Canada is a bit more than half that $3,621.
- Pomalidomide (Pomalyst): multiple myeloma, Kaposi sarcoma (list price $21,744; negotiated price $8,650)
- Palbociclib (Ibrance): breast cancer (list price $15,741; negotiated price $7,871). The price abroad is $4,699.
- Nintedanib (Ofev): idiopathic pulmonary fibrosis (list price $12,622; negotiated price $6,350). The price in Canada is $3,039.
- Linaclotide (Linzess): irritable bowel syndrome with constipation, chronic idiopathic constipation (list price $539; negotiated price $136)
- Acalabrutinib (Calquence): chronic lymphocytic leukemia/small lymphocytic lymphoma, mantle cell lymphoma (list price $14,228; negotiated price $8,600)
- Deutetrabenazine (Austedo, Austedo XR): tardive dyskinesia, chorea in Huntington’s disease (list price $6,623; negotiated price $4,093)
- Budesonide, glycopyrrolate, and formoterol fumarate (Breo Ellipta): asthma, COPD (list price $397; negotiated price $67)
- Linagliptin (Tradjenta): type 2 diabetes (list price $488; negotiated price $78)
- Rifaximin (Xifaxan): hepatic encephalopathy recurrence, irritable bowel syndrome with diarrhea (list price $2,696; negotiated price $1,000)
- Cariprazine (Vraylar): schizophrenia, bipolar I disorder, major depressive disorder (list price $1,376; negotiated price $770)
- Sitagliptin, metformin (Janumet, Janumet XR): type 2 diabetes (list price $526; negotiated price $80)
- Apremilast (Otezla): oral ulcers in Behçet’s disease, plaque psoriasis, psoriatic arthritis (list price $4,722; negotiated price $1,650)
Drugs with negotiated Medicare prices beginning in 2026, include: Dapagliflozin (Farxiga) for type 2 diabetes, heart failure, and chronic kidney disease; and etanercept (Enbrel) for rheumatoid arthritis.
Here’s more from Just Care:
- Billions in Medicare savings from Medicare drug price negotiation by 2031
- 2025: More older adults gamble with their health in Medicare Advantage
- Medicare names 10 drugs subject to price negotiation
- Case study: Costco saves one couple hundreds of dollars over Medicare Part D
- 2025: Programs that lower your costs if you have Medicare
