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Jasmine Uchi, PharmD

Exploring the Pros and Cons of Medicare Negotiating Drug Prices

Through the Inflation Reduction Act, which was signed into law on August 16, 2022, Medicare can improve access to affordable medications by now being able to negotiate prices directly with drug manufacturers as the federal health insurance for people 65 or older. Over the next 4 years, Medicare will discuss prices for about 60 drugs that are covered under Medicare Part D and Part B and continue discussing the prices of about 20 additional drugs each following year. This is a historic step forward towards the reduction of prescription drugs costs and providing many more patients access to important treatment options.


The Difference Between Medicare Parts

First Set of Drugs Selected for Medicare Price Negotiation

The Health and Human Services Department (HHS) has picked the first ten drugs for Medicare drug price negotiations. Millions of Medicare Part D enrollees rely on these 10 vital treatment options to manage life-threatening chronic conditions, but their high costs place a major financial burden on patients who need them. In 2022, people who took these drugs paid $3.4 billion out-of-pocket, while Medicare paid $50 billion.

“Far too long, pharmaceutical companies have made record profits while American families were saddled with record prices and unable to afford life-saving prescription drugs.” - HHS Secretary Xavier Becerra

Drug Name

Manufacturer

Indication

Animal-Free? (Yes/No)

Eliquis (apixaban)

Bristol-Myers Squibb​

Prevention and treatment of blood clots

No

​Jardiance (empagliflozin)

Boehringer Ingelheim and Eli Lilly

Diabetes; Heart failure

No

Xarelto (rivaroxaban)

Janssen

Prevention and treatment of blood clots; Reduction of risk for patients with coronary or peripheral artery disease

No

Januvia (sitagliptan)

Merck

Diabetes

Yes

Farxiga (dapagliflozin)

AstraZeneca

Diabetes; Heart failure; Chronic kidney disease

No

Entresto (sacubitril and valsartan)

Novartis

Heart failure

Yes

Enbrel (etanercept)

Amgen

Rheumatoid arthritis, psoriasis, psoriatic arthritis

No

Imbruvica (ibrutinib)

Pharmacyclics and Janssen

Blood cancers

No (capsules/tablets)

Unknown (oral suspension)

Stelara (ustekinumab)

Janssen

Psoriasis, psoriatic arthritis; Crohn's disease; Ulcerative colitis

No

Fiasp; Fiasp FlexTouch; FiaspFill (insulin aspart)

Novo Nordisk

Diabetes

Unknown

NovoLog, NovoLog FlexPen, NovoLog PenFill (insulin aspart)

Novo Nordisk

Diabetes

Unknown

*Unknown: Manufacturer is unable to confirm or deny whether the product contains animal-derived ingredients


Implications of Negotiation

Medicare drug price negotiation could lower costs for seniors and taxpayers, but there are some potential downsides.

  • The first round of negotiations will begin in 2023, but negotiated prices will only go into effect in 2026.

  • Drug companies may be less likely to invest in research and development with potential for reduced profits from drugs created, move overseas, delay drug releases, or focus on developing treatments for profitable diseases rather than prevalent ones.

  • Private insurers may have to pay more to make up the difference, which could lead to higher premiums and out-of-pocket costs for patients (e.g. alpha-gal patients who need to have an animal-free version of a medication which may not be part of the drug negotiation list).


Conclusion

The negotiation of drug prices is a complex issue, but it is one that is essential to addressing the high cost of prescription drugs in the United States. Medicare has the potential to be a powerful force in bringing down drug prices, but it is important to highlight that it brings both positive and negative possibilities. While it can certainly alleviate financial burdens for seniors and taxpayers, potential drawbacks like reduced innovation, increased costs for private insurance, and limited drug accessibility underscore the complexity of this issue. Some of these drawbacks may especially affect vulnerable groups such as alpha-gal patients, with whom we work closely here at VeganMed. As we move forward, it's essential to recognize these potential implications and conduct further research to gain a comprehensive understanding of the true impact that drug price negotiations might have on healthcare and the pharmaceutical industry. Only then can we ensure that everyone has access to the affordable, quality care they deserve.


 

Disclaimer: The product and/or information provided on VeganMed is of a general nature and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. We do not lab test the products to confirm that they are free from animal ingredients, and it is possible that the formulation and ingredients could have changed. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or product. The information provided in this post is accurate and up to date as of the date it was written. However, please note that circumstances and facts may change over time, and new information may become available that could alter the accuracy or relevance of the content. We encourage readers to verify and cross-reference any information provided here with trusted sources or consult relevant professionals for the most current and accurate updates.


 

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As a reminder, please comment on our FDA Citizen Petition, requesting clear labeling of animal-derived ingredients in medications. Together, we can make a difference.


If you have any further questions about ingredients in your medicines and supplements, feel free to reach out to the VeganMed team!




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