CMS initially selected ten drugs covered under Part D for the first cycle of negotiations with drug companies. These drugs include Januvia, NovoLog, Farigia, Enbrel, Jardiance, Stelara, Xarelto, Eilquis, Entresto, and Imbruvica. The new pricing will go into effect January 1, 2026. It is estimated that had the drug prices been in effect in 2023, it would have saved $6 billion in net covered prescription drug costs, or approximately 22 percent, across the 10 selected drugs. (Ref. Source 1) Click HERE to see the fact sheet.
On January 17, 2025, CMS announced the next 15 drugs for the second cycle of negotiations. These drugs include (1) Ozempic, Rybelsus, Wegovy; (2) Trelegy, Ellipta; (3) Xtandi; (4) Pomalyst; (5) Ibrance; (6) Ofev; (7) Linzess; (8) Calquence; (9) Austedo, Austedo XR; (10) Breo, Ellipta; (11) Tradjenta; (12) Xifaxan; (13) Vraylar; (14) Janumet, Janumet XR; (15) Otezla. (Ref. Source 1) If the selected drug companies agree to participate in the program, the new drug prices will go into effective January 1, 2027.
In addition to the new drug pricing, Medicare Part D beneficiaries will also benefit from the new $2000 out-of-pocket cap which went into effect January 1, 2025. For more information on the $2000 out-of-pocket cap, go to https://aspe.hhs.gov/reports/impact-ira-2000-cap.
References/Additional Information:
(2) https://www.cms.gov/files/document/factsheet-medicare-negotiation-selected-drug-list-ipay-2027.pdf