The Next Batch of Medicare Drugs Up for Price Negotiation

January 17, 2025

Today, CMS released the next round of Medicare Part D drugs that will be up for price negotiation, including the high-profile diabetes and weight loss drugs Ozempic and Wegovy.

The price negotiation is part of the Inflation Reduction Act and the broader initiative to control the price of costly Medicare drugs. The program is focused on single-source products that make up a significant share of Medicare drug spending.

“HHS will continue negotiating in the best interest of people with Medicare to have access to innovative, life-saving treatments at lower costs,” Health and Human Services Secretary Xavier Becerra said in a statement.

Here’s what you need to know:

• The drugs:  The 15 drugs for the next cycle of negotiations include:
  • Ozempic, Rybelsus, and Wegovy (Type 2 diabetes, cardiovascular disease with obesity)
  • Trelegy Ellipta (asthma, chronic obstructive pulmonary disease)
  • Xtandi (prostate cancer)
  • Pomalyst (Kaposi sarcoma, Multiple myeloma)
  • Ibrance (breast cancer)
  • Ofev (idiopathic pulmonary fibrosis)
  • Linzess (chronic idiopathic constipation, irritable bowel syndrome with constipation)
  • Calquence (chronic lymphocytic leukemia/small lymphocytic lymphoma; mantle cell lymphoma)
  • Austedo and Austedo XR (chorea in Huntington’s disease, Tardive dyskinesia)
  • Breo Ellipta (asthma, chronic obstructive pulmonary disease)
  • Tradjenta (type 2 diabetes)
  • Xifaxan (hepatic encephalopathy, irritable bowel syndrome with diarrhea)
  • Vraylar (bipolar I disorder, major depressive disorder, schizophrenia);
  • Janumet and Janumet XR (Type 2 diabetes)
  • Otezla (oral ulcers in Behçet’s Disease, plaque psoriasis, and psoriatic arthritis)
• Total share:  The selected drugs for round two accounted for about $41 billion in total gross covered prescription drug costs under Medicare Part D, or about 14 percent, federal officials said.
• The process:  The drug companies will have until February 28 to decide if they will participate in negotiations. After negotiations, the target date for the new prices would go into effect during 2027.
• Things to watch:  The release of a new class of GLP-1 drugs has been a source of scrutiny due to high costs.
  • The future of Medicare’s drug negotiation program may also be unclear, with a new presidential administration and new leadership within CMS at the start of the year.
• Quotable:  “Improving prescription drug affordability for Medicare enrollees is the core of the Inflation Reduction Act, and the next cycle of negotiations will continue to strengthen Medicare for generations to come,” said CMS Administrator Chiquita Brooks-LaSure.

A fact sheet about the next round of negotiations is available online. The prices from the first round of negotiations will become effective starting January 1, 2026.