Factbox-Top Medicare drugs headed for price cuts
2024.08.15 05:22
By Patrick Wingrove
(Reuters) – The Biden administration selected 10 prescription medicines for unprecedented price negotiations by the Medicare health program for older Americans that covers 66 million people.
Below are details on the drugs, including their gross cost to Medicare between May 2022 and June 2023:
Eliquis
Blood thinner Eliquis from Bristol Myers (NYSE:) Squibb and Pfizer (NYSE:) has been one of the most expensive drugs for the Medicare health system to cover, according to the Centers for Medicare & Medicaid Services, costing it $16.5 billion for the 12 months ending June 2023.
The drug was used to treat blood clots in around 3.7 million Medicare enrollees, helping reduce the risk of stroke and similar conditions.
Jardiance
Boehringer Ingelheim and Eli Lilly (NYSE:)’s Jardiance is used to treat type-2 diabetes, heart failure and chronic kidney disease. It cost Medicare $7 billion for 1.6 million patients in the same period, making it the second most expensive drug.
Xarelto
Eliquis rival Xarelto from Johnson & Johnson (NYSE:) cost Medicare more than $6 billion between June 2022 and May 2023. The bloodthinner, which was used to treat 1.3 million enrollees, can lower the risk of stroke, deep vein thrombosis, pulmonary embolism and similar conditions.
Januvia
Merck & Co’s Januvia, used to help lower blood glucose levels in adults with type-2 diabetes, was prescribed to 869,000 patients with Medicare coverage in the year ending June 2023 at a gross cost of $4.1 billion.
Farxiga
The third diabetes drug on the government’s list is Farxiga from AstraZeneca (NASDAQ:), which is also used to treat adults with heart failure and chronic kidney disease. It cost Medicare $3.3 billion for the 12 months ending June 2023, for nearly 800,000 patients.
Entresto
Novartis (SIX:)’ heart failure drug Entresto cost the Medicare agency $2.9 billion to treat almost 60,000 patients in the same period.
Enbrel
Enbrel, which is made by Amgen (NASDAQ:), is used to treat a range of autoimmune conditions, including rheumatoid arthritis and psoriasis. It cost Medicare $2.8 billion to treat 48,000 patients between May 2022 and June 2023.
Imbruvica
AbbVie (NYSE:) and J&J’s leukemia treatment Imbruvica cost the federal health plan $2.7 billion to treat 20,000 people in those 12 months.
Stelara
The blockbuster biologic Stelara from J&J, also used to treat autoimmune conditions such as Crohn’s disease, came at a gross cost of $2.6 billion to Medicare in that period and was used to treat 22,000 enrollees. Biosimilar rivals of the drug are expected to launch in the U.S. from January 2025, a year before the government’s negotiated prices go into effect.
NovoLog, Fiasp (insulin aspart)
Novo Nordisk (NYSE:)’s insulin aspart products, including NovoLog and Fiasp, were also included in the negotiations, having cost $2.6 billion to treat more than 750,000 people in the 12 months ending June 2023. Insulin helps manage blood glucose levels in people with type 1 and type 2 diabetes.
President Joe Biden’s Inflation Reduction Act, which allowed the government to negotiate the prices of these drugs, also capped insulin out-of-pocket spending at $35 for a month’s supply of each insulin product covered by Medicare.
