Researchers in the U.S. have compiled a list of drugs that are anticipated to be part of the Medicare Part D drug price negotiations in 2025. The Center for Medicaid Services (CMS) initiated negotiations for 10 Medicare Part D drugs in August of this year and is projected to release a second list encompassing 15 drugs by February 2025. Prominently topping the anticipated list is Novo Nordisk’s semaglutide, a Type 2 diabetes and weight loss drug marketed under the brand names Ozempic, Rybelsus, and Wegovy.
In a study published in the Journal of Managed Care & Specialty Pharmacy, researchers from the University of Washington and University of California San Diego utilized CMS guidelines and selection criteria from the Inflation Reduction Act (IRA) to calculate the projected spending on Medicare Part D drugs and to predict the most likely candidates. The criteria are as follows:
- A single-manufacturer drug ranking within the top-50 in Medicare Part D expenditure.
- Chemical drugs that have been on the market for a minimum of 7 years without available generic versions (excluding authorized generics).
- Biologic drugs that have been on the market for at least 11 years without biosimilar versions (excluding authorized biosimilars) currently available or set to be launched within the next 2 years.
The following are excluded from the list:
- Orphan drugs approved for only one indication (though orphan drugs with multiple indications are eligible).
- Any drug with Medicare expenditure of less than USD 200 million.
- Biologic products derived from human blood or plasma.
- Products from small biotech companies (defined as a company where one product accounts for at least 80% of all revenues).
The researchers identified 13 products as ‘likely’ to be included in the 2025 negotiations, with 7 products having an ‘uncertain’ negotiation status. An additional 22 drugs were found to have similar Medicare Part D spending but were ineligible due to the availability of generics or biosimilars or insufficient market presence.- Flcube.com
