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The Wall Street Publication > Blog > Lifestyle > Ozempic, Wegovy amongst medication topic to Medicare worth controls
Lifestyle

Ozempic, Wegovy amongst medication topic to Medicare worth controls

Editorial Board Published January 17, 2025
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Ozempic, Wegovy amongst medication topic to Medicare worth controls
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Dr. Alexandra Sowa joins ‘Varney & Co.’ to debate weight-loss medication changing into broadly accessible and RFK Jr.’s push to ban pharmaceutical tv advertisements and processed meals.

Extremely coveted weight-loss associated diabetes medication produced by Danish drugmaker Novo Nordisk are among the many drugs that might be topic to cost controls by Medicare.

On Friday, the Facilities for Medicare & Medicaid Companies (CMS) launched the second listing of prescription drugs lined beneath Medicare Half D. The listing has 15 medication, touted as an effort to assist decrease the monetary burden for tens of millions of sufferers who’re 65 years and older. 

It consists of Novo Nordisk’s weight reduction and diabetes medication Wegovy and Ozempic, in addition to Xtandi, Ibrance, Calquence and Pomalyst, medication that deal with prostate, breast, blood and bone marrow cancers. Worth controls for the just lately chosen medication will change into efficient in 2027. 

OALITION CALLS ON CONGRESS TO REPEAL BIDEN’S PRESCRIPTION DRUG PRICE CONTROLS

Beneath the Inflation Discount Act (IRA), which was signed into regulation in 2022, Medicare was given the authority to set decrease costs on chosen lined high-expenditure medication. 

Whereas the IRA refers to “negotiation,” the textual content of the laws permits the CMS to set a “maximum fair price” for a drug. The pharmaceutical firm then should “enter into agreement” for the worth. If they don’t, the federal government will assess a day by day excise tax on each drug offered over the “maximum fair price.” 

The transfer has confronted criticism from drugmakers, together with Novo Nordisk, which instructed FOX Enterprise that it “remains opposed to government price setting through the IRA and has significant concerns about how the law is being implemented by this administration, including aggregating multiple products that individually would not meet the requirements of the statute.”

The corporate believes the price-setting course of, which might “negatively impact patients’ ability to access their medicines and threatens to stifle future scientific development of life-changing medicines for chronic diseases in which there is a real unmet need.”

In October 2023, shortly after the primary 10 medication have been introduced, a coalition of greater than 40 teams known as on Congress to repeal the Drug Worth Negotiation Program included within the IRA, arguing that the worth management scheme run by the Biden administration will in the end result in shortages of medicines and better prices.

Beneath the Inflation Discount Act, Medicare was given the authority to set decrease costs on chosen lined high-expenditure medication. (Photograph by Andreas Arnold/image alliance through Getty Photographs / Getty Photographs)

The coalition of greater than 40 teams despatched a letter to federal lawmakers shortly after the Biden administration launched their first listing of 10 medication, which included Merck’s diabetes drug Januvia, Johnson & Johnson’s blood thinner Xarelto, in addition to Pfizer and Bristol Myers Squibb’s blood thinner Eliquis, in August 2023.

BIDEN ADMIN NAMES FIRST 10 DRUGS SUBJECT TO MEDICARE PRICE NEGOTIATION

Based on the administration, about 5.3 million Medicare Half D recipients used the newly chosen medication for situations like most cancers, Sort 2 diabetes, and bronchial asthma between November 2023 to October 2024. Throughout that point, the medication made up round $41 billion, or 14%, of complete Medicare Half D prescription prices.

pharmacy

The Biden administration has launched one other listing of prescriptions medication that may be topic to cost controls. (Jeffrey Greenberg/Schooling Photographs/Common Photographs Group through Getty Photographs / Getty Photographs)

“Last year we proved that negotiating for lower drug prices works. Now we plan to build on that record by negotiating for lower prices for 15 additional important drugs for seniors,” Division of Well being and Human Companies Secretary Xavier Becerra mentioned. 

Becerra mentioned the company “will continue negotiating in the best interest of people with Medicare to have access to innovative, life-saving treatments at lower costs.”

Walgreens

Pharmacist Tzofit Moskovich, left, works at a pc station as Michelle Sorto, a senior pharmacy technician for Walgreen Co., kinds recordsdata at a retailer in Oak Park, Illinois, on Tuesday, Dec. 20, 2011. (Daniel Acker/Bloomberg through Getty Photographs / Getty Photographs)

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Right here is the chosen drug listing for the second cycle of negotiations:Ozempic; Rybelsus; WegovyTrelegy ElliptaXtandiPomalystIbranceOfevLinzessCalquenceAustedo; Austedo XRBreo ElliptaTradjentaXifaxanVraylarJanumet; Janumet XROtezla

TAGGED:AmongcontrolsdrugsMedicareOzempicpricesubjectWegovy
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