Federal laws handed in 2022 referred to as for Medicare to barter prescription drug costs with pharmaceutical firms. A number of of them have sued to cease the method.
Nonetheless, the federal authorities in late 2023 chosen the primary batch of medication to haggle over. And a latest evaluation of Medicare information from nonprofit well being coverage group KFF highlights the best way this technique may work.
KFF discovered {that a} handful of prescribed drugs made up practically 1 / 4 of the federal medical insurance program’s Half D spending — practically $48 billion of $216 billion — in 2021. Medicare Half D lined 3,566 medication in 2021.
Following are the prescribed drugs that account for the biggest share of Medicare spending.
10. Ozempic
Complete Medicare spending on this prescription drug in 2021: $2.6 billion
Variety of folks utilizing this drug in 2021: 458,600
Ozempic, which boosts the physique’s pure insulin manufacturing, helps diabetics handle blood sugar and lowers the danger of coronary heart assault. It additionally suppresses urge for food, which can result in weight reduction.
It’s made by Novo Nordisk. The drug was accepted too lately (2017) to be half of the present spherical of value negotiations, KFF says.
9. Lantus SoloStar
Complete Medicare spending on this prescription drug in 2021: $2.8 billion
Variety of folks utilizing this drug in 2021: 1.1 million
Lantus SoloStar is an insulin product made by Sanofi.
Due to an different referred to as Semglee, Lantus gained’t be a part of present value negotiations. The Lantus maker additionally lower the worth of the drug by 78% in early 2023.
8. Humira pen (citrate-free)
Complete Medicare spending on this prescription drug in 2021: $2.9 billion
Variety of folks utilizing this drug in 2021: 51,200
Humira is a prescription drug used to deal with arthritis, psoriasis and Crohn’s illness, amongst others. It’s made by AbbVie.
As a result of alternate options to Humira exist, it wasn’t chosen for value negotiations.
7. Imbruvica
Complete Medicare spending on this prescription drug in 2021: $3.2 billion
Variety of folks utilizing this drug in 2021: 26,000
Imbruvica is a most cancers therapy drug made by Pharmacyclics and Janssen, pharmaceutical firms owned by AbbVie and Johnson & Johnson, respectively.
It has the second-highest common spending per beneficiary among the many medication on this listing — $121,000 per particular person. (Most are roughly between $3,000 and $7,000.)
Fortuitously, Imbruvica was chosen for Medicare’s first spherical of value negotiations.
6. Jardiance
Complete Medicare spending on this prescription drug in 2021: $3.7 billion
Variety of folks utilizing this drug in 2021: 884,500
One other of the diabetes medication within the prime 10, Jardiance is made by Eli Lilly and Boehringer Ingelheim. Like Imbruvica, Jardiance was chosen for value negotiations.
5. Januvia
Complete Medicare spending on this prescription drug in 2021: $4.1 billion
Variety of folks utilizing this drug in 2021: 934,500
Januvia, which may value as little as $5 per prescription by means of non-public insurance coverage, helps handle blood sugar for sort 2 diabetics. It’s made by Merck and was chosen for the primary spherical of Medicare value negotiations.
4. Trulicity
Complete Medicare spending on this prescription drug in 2021: $4.7 billion
Variety of folks utilizing this drug in 2021: 663,900
Trulicity is one other drug used to deal with Sort 2 diabetes made by Eli Lilly.
The drug was accepted too lately (2014) to be half of the present spherical of Medicare value negotiations.
3. Xarelto
Complete Medicare spending on this prescription drug in 2021: $5.2 billion
Variety of folks utilizing this drug in 2021: 1.3 million
Xarelto is used to scale back the danger of blood clots and strokes. It’s made by Janssen and was chosen for the primary spherical of Medicare drug value negotiations.
2. Revlimid
Complete Medicare spending on this prescription drug in 2021: $5.9 billion
Variety of folks utilizing this drug in 2021: 45,600
Revlimid is a cancer-treating drug made by Bristol Myers Squibb. It’s the most costly drug per beneficiary on this listing, at $129,000 per particular person.
As a result of there may be now a generic model of Revlimid being steadily launched to the market, it gained’t be a part of present value negotiations.
1. Eliquis
Complete Medicare spending on this prescription drug in 2021: $12.6 billion
Variety of folks utilizing this drug in 2021: 3.1 million
Eliquis is made by Pfizer. It’s a blood thinner used to scale back the danger of stroke and blood clots. It was chosen for value negotiations.
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