Potential Targets Emerge for Upcoming Medicare Price Negotiations

March 1, 2023

With Medicare negotiations beginning in 2026, some major sellers by Novo Nordisk, Eli Lilly, and Merck are likely early targets of the drug pricing reforms included in the US Inflation Reduction Act (IRA). This includes diabetes drugs like Januvia by Merck and cancer drugs like Pfizer’s Ibrance and Xtandi. However, some of the most expensive drugs in the nation are off the table.

According to Fraiser Kansteiner, “Under IRA’s cost negotiation provisions, a drug loses eligibility for inclusion in pricing talks when a generic or biosimilar version has been approved and marketed for at least nine months ahead of the first of the year when negotiated prices would apply. Between 2026 and 2028, major players like Bristol’s Revlimid and AbbVie’s Humira will maintain discussion immunity.”

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(Source: Fierce Pharma, February 28th, 2023)

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