Ozempic, Wegovy and other drugs are among 15 selected for Medicare's
price negotiations
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[January 18, 2025]
By AMANDA SEITZ
WASHINGTON (AP) — Popular weight loss and diabetes drugs like Ozempic
and Wegovy have been added to Medicare’s list of medications that will
be negotiated directly between the government and drug manufacturers,
the Biden administration said Friday.
The price negotiations for the additional 15 drugs selected will be
handled by the incoming Trump administration and, if deals are reached,
almost assure billions of dollars in savings for taxpayers.
Besides Ozempic and Wegovy, some of the other medications include
Trelegy Ellipta, which treats asthma; Otezla, a psoriatic arthritis
drug; and several that treat different forms of cancer.
The list is a first step in negotiations and, given the timing, the
details and final pricing will be left to President-elect Donald Trump’s
administration.
“For some people this is a big deal,” U.S. Health and Human Services
Secretary Xavier Becerra said in a call with reporters on Thursday.
“Some folks have to skip a dose in their prescription so they can make a
prescription last longer.”
That brings the total to 25 drugs that will have lower price tags for
Medicare enrollees.
Together, those 25 drugs account for a third of Medicare spending on
prescriptions, Becerra said. Ozempic and Wegovy, in particular, have
been scrutinized for their high out-of-pocket costs.
Medicare enrollees, however, still won't be able to access the drugs for
obesity under a federal law that prohibits the program from paying for
weight loss treatments. Right now, Medicare will only cover Ozempic and
Wegovy when used to treat diabetes or lower blood sugar. A rule the
Democratic Biden administration proposed — and the incoming Republican
Trump administration will decide whether to implement — would cover the
popular anti-obesity medications for weight loss.
The savings on the 25 drugs stem from a new law that allows Medicare to
haggle over the price it pays on the most popular and expensive
prescription drug scripts filled by older Americans. For years, Medicare
had been legally prohibited from such dealmaking. The law, passed by
Democrats and signed into law by President Joe Biden, was opposed by
Republicans at the time, but it’s unclear if they have an interest in
trying to repeal or weaken the law now.
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Drug companies have sued over the negotiations and remain opposed to the
program. On Friday, the top pharmaceutical lobby called on the incoming
administration and Congress to “fix” the law.
“In rushing out this list in their final days, the Biden administration
once again fails to address the true challenges facing seniors and
Medicare,” Stephen Ubl, the president and CEO of Pharmaceutical Research
and Manufacturers of America, said in a statement.
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The injectable drug Ozempic is shown, July 1, 2023, in
Houston. (AP Photo/David J. Phillip, File)
 Late last year, the Centers for
Medicare & Medicaid Services announced it had reached pricing deals
with companies for 10 drugs in the inaugural round of negotiations.
Under the new deals, list prices were reduced by hundreds — in some
cases, thousands — of dollars for 30-day supplies of popular drugs
used by millions of people on Medicare. They included popular blood
thinners Xarelto and Eliquis and diabetes drugs Jardiance and
Januvia. Drug company executives told investors during earnings
calls that they did not expect the negotiations to impact their
bottom line.
The AARP, one of the most powerful health care interest groups in
Washington, said that it would fight any efforts to weaken the law
in the GOP-controlled Congress.
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“For too long, big drug companies have padded their profits by
setting outrageous prices at the expense of American lives, forcing
seniors to skip prescriptions they can’t afford," AARP Executive
Vice President Nancy LeaMond said in a statement.
The savings from the new list prices for those drugs were expected
to generate about $6 billion for taxpayers and $1.5 billion for
Medicare enrollees.
Negotiated prices for the first 10 drugs don’t kick in until 2026.
Prices for the 15 additional drugs announced today won't go into
effect until 2027. But some Medicare enrollees should see relief
from drug prices in a new rule this year that caps annual
out-of-pocket costs on prescription drugs to $2,000.
Under the law, more drugs will be added to the negotiation process
in coming years.
The Centers for Medicare & Medicaid Services says the 15 drugs are
Ozempic, Rybelsus and Wegovy; Trelegy Ellipta; Xtandi; Pomalyst;
Ibrance; Ofev; Linzess; Calquence; Austedo and Austedo XR; Breo
Ellipta; Tradjenta; Xifaxan; Vraylar; Janumet and Janumet XR; and
Otezla.
Ozempic and Wegovy are made by Novo Nordisk, which is based in
Denmark and has U.S. headquarters Plainsboro, New Jersey.
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