Third round of Medicare price negotiations adds fifteen drugs, including the first physician-administered medicines
The list covers treatments that accounted for about $41 billion in spending last year. Negotiated prices take effect in 2028.
By Meera RaghunathanPublished · 1 min read
Federal health officials on Wednesday named the fifteen medicines selected for the third cycle of Medicare price negotiation, the first to include drugs given in clinics and hospitals rather than picked up at a pharmacy.
Cancer treatments make up six of the fifteen. The remainder are spread across diabetes, autoimmune disease and respiratory illness.
Manufacturers have until the end of October to decide whether to participate. Declining means either paying a steep excise tax or withdrawing all products from Medicare and Medicaid, and no company has chosen that route in the first two rounds.
What changes this time
Negotiating over physician-administered drugs is more complicated because doctors are reimbursed based on a product's average sales price. Lower prices could reduce clinic revenue, and oncology groups have asked for an adjustment.
Drugmakers argue the program discourages investment in pills, which become eligible for negotiation four years sooner than biologic drugs. A bill to equalize the timelines has bipartisan sponsors but has not advanced.