The 10 drugs that CMS might wrangle into negotiations

CMS plans to soon release its list of 10 drugs that are up for price negotiations as it gears up to wield new powers granted by the Inflation Reduction Act, which passed in August 2022. 

Researchers from the Washington, D.C.-based West Health Policy Center and the University of California San Diego studied which drugs might be chosen by CMS. They evaluated drug age — since only those older than a decade are eligible — Part B and Part D gross spending in 2020, and estimates of when a drug will lose its exclusivity status. 

The first phase of negotiations are expected to become effective in 2026, and the researchers said the negotiations have the potential to save CMS $3.7 billion in the first rollout. 

The 10 drugs most likely to be chosen for CMS negotiations, according to the study:

1. Eliquis (apixaban): A drug made by Bristol Myers Squibb and Pfizer that's approved for reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. It's also approved for the prophylaxis of deep vein thrombosis, which can lead to pulmonary embolism in patients who have undergone hip or knee replacement surgery. 

2. Xarelto (rivaroxaban): A Janssen therapy that reduces the risk of stroke and blood clots in people who have atrial fibrillation not caused by a heart valve problem. 

3. Januvia (sitagliptin phosphate): A Merck drug for Type 2 diabetes. 

4. Imbruvica (ibrutinib): A Pharmacyclics medication for mantle cell lymphoma, chronic lymphocytic leukemia, small lymphocytic lymphoma and marginal zone lymphoma. 

5. Jardiance (empagliflozin): A Type 2 diabetes drug made by Boehringer Ingelheim Pharmaceuticals.

6. Enbrel (etanercept): An Amgen drug approved for rheumatoid arthritis and psoriatic arthritis.

7. Symbicort (budesonide/formoterol): An asthma treatment and chronic obstructive pulmonary disease drug made by AstraZeneca

8. Ibrance (palbociclib): A Pfizer breast cancer medication.

9. Xtandi (enzalutamide): A medication made by Astellas Pharma that's approved for castration-resistant prostate cancer. 

10. Breo Ellipta (fluticasone/vilanterol): A Glaxosmithkline drug for asthma. It's also indicated for treating airflow obstruction and reducing exacerbations in patients with chronic obstructive pulmonary disease.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars