More than 40,000 Mainers may benefit from the federal government’s first-ever negotiations with drug companies on the prices of numerous Medicare drugs.
President Joe Biden’s administration announced Tuesday the 10 drugs that will be a part of price negotiations between Medicare, the government’s health insurance program for Americans over 65 years old, and drugmakers. The drugs treat common conditions such as diabetes, arthritis, blood clots and heart failure.
The negotiations on Part D drugs were authorized by the Inflation Reduction Act, a wide-ranging piece of legislation that Congress narrowly passed along party lines last August.
Vice President Kamala Harris had to break a 50-50 tie on the bill in the U.S. Senate, with Sen. Angus King, I-Maine, voting yes and Sen. Susan Collins, R-Maine, joining all Republicans in voting no. In the U.S. House, Democratic Reps. Chellie Pingree and Jared Golden each voted to pass it.
Which drugs are included in the Medicare price negotiations?
These are the 10 drugs up for negotiations and the conditions they treat, along with data from the Department of Health and Human Services on the number of Mainers receiving them and their average out-of-pocket costs:
– Eliquis (blood clots), 21,000 Maine enrollees, $413
– Jardiance (diabetes, heart failure), 7,000 Maine enrollees, $262
– Xarelto (blood clots, coronary or peripheral artery disease), 6,000 Maine enrollees, $432
– Januvia (diabetes), 4,000 Maine enrollees, $228
– Farxiga (diabetes, heart failure, chronic kidney disease), 2,000 Maine enrollees, $223
– Entresto (heart failure), 1,000 Maine enrollees, $338
– Enbrel (rheumatoid arthritis, psoriasis, psoriatic arthritis), fewer than 500 Maine enrollees, $940
– Imbruvica (blood cancers), fewer than 500 Maine enrollees, $4,994
– Stelara (psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis), fewer than 500 Maine enrollees, $1,783
– Fiasp, Fiasp FlexTouch, Fiasp PenFill, NovoLog, NovoLog FlexPen and NovoLog PenFill (diabetes), 4,000 Maine enrollees, $89
Drug companies could use litigation to disrupt negotiations, which also face criticism from Republicans. Former President Donald Trump supported Medicare drug price negotiations on the 2016 campaign trail before backing off the idea. Polling shows broad support for the concept among Americans, regardless of political party.
When could Mainers on Medicare see cheaper drug prices?
Residents of Maine, which is the oldest state in the U.S. based on median age and has more than a quarter of its population enrolled in Medicare, won’t see new prices right away. The Centers for Medicare and Medicaid Services will publish any agreed-upon negotiated prices for the 10 drugs by Sept. 1, 2024, and those prices would take effect starting in 2026.
The government will then choose up to 15 more drugs for price negotiations in both 2027 and 2028, and up to 20 more drugs each year after that, under the Inflation Reduction Act, which also included limits on Part D premium increases and insulin copays, and established other cost caps.
