HHS Announces 10 Drugs Selected for Medicare Drug Price Negotiation
Price negotiation seems likely to improve treatment adherence in orthopaedic patients by keeping patients’ costs down.
What
For the first time, Medicare is authorized to negotiate the prices of prescription drugs. On August 29, 2023, the U.S. Department of Health and Human Services (HHS) announced the first 10 drugs covered by Medicare Part D that were selected for negotiation. The Inflation Reduction Act authorizes the HHS Secretary to negotiate prices directly with participating manufacturers for selected drugs that have a high total spending and are high-expenditure, single-source drugs without generic or biosimilar competition. Of those selected, several either are commonly prescribed by orthopaedic surgeons (the anticoagulants Eliquis and Xarelto) or often used by their patients (the biologic Enbrel, several medications to treat Type 2 diabetes, and one for psoriatic arthritis). The selected drugs contributed $3.4 billion in out-of-pocket costs for Medicare beneficiaries in 2022.
When
The Inflation Reduction Act was signed into law on August 16, 2022. The first 10 drugs selected for negotiation were announced a year later, on August 29, 2023. CMS will publish any agreed-upon negotiated prices for the selected drugs by September 1, 2024; those prices will come into effect starting January 1, 2026. In future years, CMS will select for negotiation up to 15 more drugs covered under Part D for 2027, up to 15 more drugs for 2028, and up to 20 more drugs for each year after that, as outlined in the Inflation Reduction Act.
