WASHINGTON — The Trump administration on Tuesday released the next 15 drugs subject to Medicare price negotiation, including for the first time treatments administered in doctor offices.
This is the third round of drugs selected for price negotiation and the first year that physician-administered drugs in Part B are eligible for price negotiation. Only retail drugs covered by Part D were eligible during the first two years.
Trump administration quietly unveils new round of Medicare-negotiated drug prices
The negotiated prices for drugs chosen this year will take effect in 2028.
The Trump administration has downplayed the Medicare price negotiation program, a signature achievement of the Biden administration that all Republicans voted against. Instead, Trump has touted the voluntary agreements that drugmakers have struck with his administration to charge prices that are on par with prices in other rich countries.
Centers for Medicare and Medicaid Services Administrator Mehmet Oz praised Trump for the new list.
“Under President Trump’s leadership, CMS is taking strong action to target the most expensive drugs in Medicare, negotiate fair prices, and make sure the system works for patients — not special interests,” Oz said in a press release.
Some cancer and HIV drugs will likely generate big savings because of their protected-class status in Medicare. Private Medicare plans must cover protected-class drugs, and researchers have found that insurers negotiate smaller rebates on those drugs because of that restriction. That makes them ripe for bigger discounts.
Drugs in that category include Biktarvy, an antiretroviral that treats HIV; Verzenio, a breast cancer therapy; Erleada, a prostate cancer drug; and Lenvima, a cancer therapy.
The addition of physician-administered drugs presents a challenge. Medicare gets the same detailed records of health care services, called claims data, on all retail drugs. That process is more complicated in Part B. The government has spending amounts for Part B drugs paid for by traditional Medicare, but does not know prices for Part B drugs covered by Medicare Advantage plans, which enroll more than half of Medicare beneficiaries. Medicare does get utilization data on those drugs.
Six of drugs are often administered in doctor offices, though some are available for self-administration too, which would be covered by Part D.
Here is a list of the drugs, along with what they treat and their makers:
Anoro Ellipta, chronic obstructive pulmonary disease. (GlaxoSmithKline)
Biktarvy, HIV. (Gilead Sciences)
Botox and Botox Cosmetic, several cosmetic and therapeutic uses, including chronic migraines. (AbbVie)
Cimzia, rheumatoid arthritis, Crohn’s disease, and other autoimmune conditions. (UCB)
Cosentyx, autoimmune conditions including plaque psoriasis. (Novartis)
Entyvio, active ulcerative colitis and Crohn’s disease. (Takeda)
Erleada, prostate cancer. (Janssen Biotech)
Kisqali, breast cancer. (Novartis)
Lenvima, advanced cancers. (Eisai)
Orencia, rheumatoid arthritis and psoriatic arthritis. (Bristol-Myers Squibb)
Rexulti, schizophrenia. (Otsuka Pharmaceuticals)
Trulicity, cardiovascular diseases. (Eli Lilly)
Verzenio, breast cancer. (Eli Lilly)
Xeljanz and Xeljanz XR, rheumatoid arthritis and multiple other inflammatory conditions. (Pfizer)
Xolair, asthma and other allergic reactions. (Genentech)