Pharma’s Medicare counteroffers are all in, says HHS

Pharma’s Medicare counteroffers are all in, says HHS

On the heels of a setback in pharma’s legal attempts to block Medicare’s new medicine price negotiation powers, the US government has said all drugmakers whose products are up for discussion have engaged with the process by filing counteroffers.

US Department of Health and Human Services (HHS) Secretary Xavier Becerra said the milestone showed that the federal government is “committed to constructive dialogue” with the industry through “good-faith, upfront negotiations.”

10 drugs have been selected for the first round of negotiations, which are expected to continue over the next several months and come to a conclusion on 1st August. If an agreement is reached, the new prices will be published on 1st September and come into effect at the start of 2026.

The full list of medicines – which are all deemed by HHS to have a “high budget impact “ on Medicare – appears below:

  • Bristol-Myers Squibb and Pfizer’s Eliquis (apixaban)
  • Novartis’ Entresto (valsartan/sacubitril)
  • Amgen’s Enbrel (etanercept)
  • AstraZeneca’s Farxiga (dapagliflozin)
  • AbbVie and Johnson & Johnson’s Imbruvica (ibrutinib)
  • Merck & Co/MSD’s Januvia (sitagliptin)
  • Eli Lilly/Boehringer Ingelheim’s Jardiance (empagliflozin)
  • Novo Nordisk’s Novolog/Fiasp (insulin aspart)
  • Johnson & Johnson’s Stelara (ustekinumab)
  • Johnson & Johnson’s Xarelto (rivaroxaban)

Becerra said that the negotiation process introduced as part of the 2022 Inflation Reduction Act (IRA) is a “cornerstone” of the government’s efforts to “lower costs for families and keep money in the pockets of millions of Americans instead of big pharma.”

HHS’ announcement came shortly after a US federal judge rejected a challenge from AstraZeneca over the legality of Medicare’s pricing negotiation powers, saying the company had not identified anything protected by constitutional rights that the programme would jeopardise.

That result came after a federal judge in Texas threw out a lawsuit brought by the Pharmaceutical Research and Manufacturers of America (PhRMA) trade organisation and another in Ohio denied a preliminary injunction that had been sought by the US Chamber of Commerce.

HHS has also published a fact sheet claiming that the IRA would lead to significant reductions in drug costs for people living in rural areas accessing care through Medicare Part D, a voluntary outpatient prescription drug benefit.

The report claims that people living in rural communities with limited income who are enrolled in the Extra Help programme, around 300,000 people at last count, will save about an average of $300 annually thanks to the legislation.