WASHINGTON — The Biden administration has announced that popular weight loss and diabetes medications, including Ozempic and Wegovy, will now be part of the list of drugs subject to direct price negotiations between Medicare and pharmaceutical manufacturers. This development is expected to lead to significant savings for taxpayers.
The negotiations will encompass 15 additional drugs, potentially resulting in billions of dollars in savings. Alongside Ozempic and Wegovy, other medications involved include Trelegy Ellipta for asthma, Otezla for psoriatic arthritis, and various treatments for different forms of cancer.
This marks a critical first step in negotiations, with the responsibility for final pricing and details shifting to the new administration. “For many individuals, this is a significant matter,” U.S. Health and Human Services officials stated. “Some patients are forced to ration their medications to cope with high costs.”
With these additions, the total number of drugs benefiting from price reductions for Medicare recipients has now reached 25, accounting for roughly one-third of Medicare’s prescription spending. Ozempic and Wegovy have drawn particular attention due to their steep out-of-pocket expenses.
Currently, Medicare cannot cover obesity treatments. Coverage for Ozempic and Wegovy is limited to diabetes management. There is a proposed rule under consideration that could expand coverage to include these essential anti-obesity treatments.
The price reductions are made possible through new legislation that allows Medicare to negotiate prices for its most costly prescriptions—a practice previously prohibited. Despite bipartisan contention surrounding the law’s passage, its implications are expected to remain intact.
Pharmaceutical companies have expressed strong opposition to the negotiation program, with major industry groups calling on the new administration and Congress to amend the law, highlighting ongoing concerns about its impact on seniors and Medicare overall.
Success from earlier negotiations was evident as Medicare secured lower prices for 10 additional drugs, significantly reducing costs for essential medications used widely among Medicare beneficiaries.
As future negotiations are anticipated, new rules introduced this year aim to alleviate financial burdens further, capping annual out-of-pocket expenses at $2,000 for Medicare enrollees.
The Centers for Medicare and Medicaid Services has identified the 15 newly negotiated drugs, including Ozempic, Rybelsus, Wegovy, and others, demonstrating a commitment to addressing the rising costs of prescription medication for seniors.
