Medicare to Negotiate Prices for Ozempic, Wegovy, and Other High-Cost Drugs
WASHINGTON — In a critically important move aimed at reducing prescription drug costs, the Biden administration announced Friday that popular weight loss and diabetes medications like Ozempic and Wegovy have been added to Medicare’s list of drugs subject to price negotiations.This decision marks a pivotal step in the government’s efforts to make essential medications more affordable for millions of Americans.
The Centers for Medicare and Medicaid Services (CMS) identified 15 additional drugs for negotiation, bringing the total to 25. These medications, which include treatments for conditions ranging from asthma to cancer, account for a staggering one-third of medicare’s prescription drug spending, according to U.S. Health and Human Services Secretary Xavier Becerra.
“For some people, this is a big deal,” Becerra said during a call with reporters. “Some folks have to skip a dose in their prescription so they can make a prescription last longer.”
The negotiations, which will be handled by the incoming Trump administration, could result in billions of dollars in savings for taxpayers. If prosperous, the deals will ensure lower out-of-pocket costs for Medicare enrollees, particularly for high-priced drugs like Ozempic and Wegovy, which have faced scrutiny for their steep prices.
Key Drugs on the Negotiation List
In addition to Ozempic and Wegovy, the list includes Trelegy Ellipta, a medication for asthma, and Otezla, used to treat psoriatic arthritis. Several cancer treatments are also among the selected drugs.
| Drug | Condition Treated |
|——————–|—————————–|
| Ozempic | Diabetes, weight Loss |
| Wegovy | Weight Loss |
| Trelegy Ellipta | Asthma |
| Otezla | Psoriatic Arthritis |
What This Means for Medicare Enrollees
The inclusion of these drugs in Medicare’s negotiation process is expected to alleviate financial burdens for many beneficiaries. Ozempic and Wegovy, in particular, have been criticized for their high costs, often forcing patients to ration their doses or forgo treatment altogether.
This initiative builds on earlier proposals by the Biden administration to expand Medicare and Medicaid coverage for weight-loss drugs like Wegovy and Ozempic. The negotiations are part of a broader strategy to address the rising costs of prescription medications, which have become a growing concern for both patients and policymakers.
The Road ahead
While the list of drugs is a critical first step, the details and final pricing will be steadfast by the incoming Trump administration. the outcome of these negotiations could set a precedent for future efforts to control drug prices and improve access to essential medications.
As the process unfolds,millions of Americans will be watching closely,hopeful for relief from the financial strain of high prescription costs. For now, the inclusion of Ozempic, Wegovy, and other high-cost drugs in Medicare’s negotiation list represents a promising step toward a more affordable healthcare system.For more details on the Biden administration’s proposals to cover weight-loss drugs, visit this related story.
Medicare Drug Price Negotiations: A Game-Changer for Seniors and Taxpayers
In a landmark move, the Centers for Medicare & Medicaid Services (CMS) has finalized pricing deals for 10 widely used prescription drugs, slashing costs by hundreds—and in some cases, thousands—of dollars for 30-day supplies. This initiative, part of the Inflation Reduction Act, marks the first time Medicare has been empowered to negotiate drug prices directly with manufacturers. The savings are projected to benefit both taxpayers and Medicare enrollees, with an estimated $6 billion in savings for taxpayers and $1.5 billion for enrollees.
The drugs included in this inaugural round of negotiations include popular blood thinners like Xarelto and Eliquis, as well as diabetes medications such as Jardiance and Januvia. While drug company executives have downplayed the impact on their bottom line, the move has been hailed as a significant step toward making prescription drugs more affordable for millions of Americans.
AARP Vows to Protect the Law
The AARP, one of the most influential health care advocacy groups in Washington, has pledged to defend the law against any attempts to weaken it. “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,” said Nancy LeaMond, AARP Executive Vice President, in a statement.
The law, passed by Democrats and signed by President Joe Biden, faced opposition from Republicans, though it remains unclear whether they will seek to repeal or modify it. Simultaneously occurring, pharmaceutical companies have filed lawsuits challenging the negotiations, and industry leaders continue to voice their discontent.
Expanded Negotiations and Future Savings
The CMS has announced an additional 15 drugs for future negotiations, including Ozempic, Wegovy, and Trelegy Ellipta. While the negotiated prices for the first 10 drugs won’t take effect until 2026, and the next 15 in 2027, Medicare enrollees will see immediate relief this year thanks to a new rule capping annual out-of-pocket prescription drug costs at $2,000.
| Key Highlights | Details |
|—————————————-|—————————————————————————–|
| drugs included in First Round | Xarelto, Eliquis, Jardiance, Januvia, and others |
| Savings | $6 billion for taxpayers, $1.5 billion for Medicare enrollees |
| Effective dates | First 10 drugs: 2026; Next 15 drugs: 2027 |
| Out-of-Pocket Cap | $2,000 annually for prescription drugs, effective 2024 |
Challenges and Controversies
Despite the potential benefits, the program faces significant pushback. Pharmaceutical companies argue that the negotiations could stifle innovation, while critics claim the process was rushed.“In rushing out this list in their final days, the Biden administration once again fails to address the true challenges facing seniors and Medicare,” said Stephen Ubl, President and CEO of the pharmaceutical Research and Manufacturers of America (PhRMA).
Additionally, Medicare enrollees still face limitations in accessing certain drugs. For example, Ozempic and Wegovy, both produced by Novo Nordisk, are only covered for diabetes treatment, not weight loss. A proposed rule by the Biden administration could expand coverage for these anti-obesity medications, but its implementation remains uncertain under the incoming administration.
Looking Ahead
The Medicare drug price negotiation program is set to expand in the coming years, with more drugs added to the list. This initiative represents a significant shift in how prescription drug prices are managed in the U.S., offering hope for millions of seniors struggling with high medication costs.
As the debate continues, one thing is clear: the fight for affordable prescription drugs is far from over.For now, Medicare enrollees can look forward to tangible savings and greater financial security in the years ahead.
By Amanda Seitz, Associated Press
