Ozempic might be in upcoming drug price talks with CMS

Ozempic might find itself in CMS' hands soon.

Sales of the Type 2 diabetes drug in the U.S. have reached more than $3 billion so far in 2023, according to an Aug. 10 quarterly report from the drug's maker, Novo Nordisk. CMS might try to influence the company to lower the medication's cost, which sits at about $1,000 per month.

In August 2022, President Joe Biden signed the Inflation Reduction Act, which gave Medicare Parts B and D negotiation powers for costly drugs with no generic or biosimilar competition. CMS said it will reveal by Sept. 1 which are the first 10 drugs that will see price negotiations, which are effective in 2026. This allowance will add more drugs each year. 

Researchers from the Washington, D.C.-based West Health Policy Center and the University of California San Diego predicted Ozempic would be chosen for these negotiations in 2027 — when it passes 10 years on the market, one of the rules of the Inflation Reduction Act provision — according to a study published in March.

In 2020, Medicare spent about $1.4 billion on Ozempic, the research found. It is the second top drug eligible for price talks in 2027. 

The medication was approved in late 2017 to treat Type 2 diabetes, and in recent months, the drug rose to fame through free celebrity endorsements and TikTok virality for its off-label use as a weight loss medication. Its popularity has shoved multiple issues to the forefront, including reports of stomachs paralyzing and patients regurgitating while undergoing anesthesia before surgeries.

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