Paul Schloesser
Associate Editor
A new paper published this week claims that in 2026, when Medicare negotiations for drug prices kick off, the minimum discount stipulated by the Inflation Reduction Act exceeds 2020 rebates for only four of the 10 drugs to be negotiated.
On Sept. 1, CMS is expected to announce those 10 drugs first subject to government price negotiations.
“These include etanercept (Enbrel), which will be subject to at least a 60% discount, up from an estimated rebate of 39.1%, and the cancer drugs ibrutinib (Imbruvica), palbociclib (Ibrance), and enzalutamide (Xtandi), all of which will be subject to a minimum discount of 25%, up from estimated rebates of 9%, 5.7%, and 15.0%, respectively,” researchers from the University of California, San Diego and Washington, DC’s West Health Policy Center wrote in the Journal of Managed Care & Specialty Pharmacy.
They note that the minimum required discount on these four drugs combined would generate savings of $1.8 billion. And for the other six drugs, the maximum negotiated price will be set by the current rebate, they say.
The authors also made predictions, published back in March, on which drugs would see negotiations in which years, based on variables such as a timeline for anticipated competition from biosimilars or generics, Part B and Part D spending in 2020, drug age and more.
Their list diverged from Wall Street analysts with Leerink Partners, which predicted only one drug on that list before the IRA was signed into law last year: Imbruvica.
Which drugs may be hit with negotiations if the reconciliation bill passes? Wall St. analysts explain
“To achieve the savings projected by the Congressional Budget Office ($3.7 billion), negotiated prices will have to fall below the ceiling for the negotiated price established by the statute,” the authors wrote.
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