Good afternoon! Wegovy, the blockbuster weight loss treatment from Novo Nordisk, tops the list of drugs that could soon become part of the second round of price negotiations between manufacturers and Medicare.
That's according to a paper published last week in the Journal of Managed Care & Specialty Pharmacy. By February, the government will unveil the next 15 costliest Medicare Part D drugs that will be subject to the talks, for price changes that will go into effect in 2027.
The Biden administration last month announced new negotiated prices for the first 10 Medicare Part D drugs selected for the talks. Those prices will take effect in 2026.
Medications containing the same active ingredient and manufactured by the same company will be considered a single drug for the talks, according to guidance from the Centers for Medicare & Medicaid Services. The researchers said that's why they expect all of Novo Nordisk's three branded drugs containing semaglutide – Wegovy, the diabetes injection Ozempic and an older diabetes pill called Rybelsus – to be selected for the talks as a single product.
That may be a big deal for older adults who use those treatments, which each carry price tags of around $1,000 per month before insurance. However, it's still unclear how much Medicare could negotiate down those costs — and how much patient costs would fall after insurance and rebates.
The Biden administration, lawmakers and patient advocates have long criticized the Danish drugmaker for the high list prices of its obesity and diabetes drugs. Novo Nordisk's CEO Lars Fruergaard Jørgensen faced a Senate grilling on Tuesday over those prices.
While Jørgensen did not commit to lowering prices of Wegovy and Ozempic, he vowed to "collaborate" with pharmacy benefit managers "on anything that helps patients get access and affordability." He also pushed back on Medicare price negotiations when asked about the potential selection of Wegovy and Ozempic, calling the talks "price-setting" that will have negative consequences for drug innovation.
Medicare Part D doesn't cover weight loss treatments unless they are approved and prescribed for another health condition. But Wegovy could make the list for negotiations because it is now approved to reduce the risk of major cardiovascular complications, making it likely that some Part D plans have started covering the treatment, according to the researchers.
Under CMS guidance, drugs must be on the market for at least seven years without generic competitors before Medicare can select them for price talks. Semaglutide will have been on the market for seven years and one month by February and does not have any generic equivalents.
Other researchers and Wall Street analysts have said they expect Ozempic to be subject to negotiations because of how much Medicare Part D spends on the treatment.
The program spent more than $5.6 billion on semaglutide drugs in 2022, which only reflects spending on Ozempic and Rybelsus since Wegovy was not covered at the time, the paper said. Researchers also projected that Medicare Part D spent nearly $7.5 billion on Ozempic and Rybelsus in 2023, which is $3 billion higher than spending for the second-highest eligible drug.
They noted they likely "underestimated" their projected spending figures for semaglutide.
The other drugs expected to be subject to price talks include GSK's Trelegy Ellipta, a prescription inhaler used to treat asthma and chronic obstructive pulmonary disease, and Xtandi, a rheumatoid arthritis medication from Astellas Pharma.
Still, researchers said the final list of drugs selected will depend on whether generic versions launch before February.
We'll be following the next round of Medicare drug price negotiations closely, so stay tuned for our coverage.
Tidak ada komentar:
Posting Komentar