Medicare is about to start negotiating the prices of medications administered by doctors

By Jaimy Lee The 15 drugs selected for negotiation include Eli Lilly's breast-cancer drug Verzenio CMS Administrator Mehmet Oz said the agency is taking "strong action" to address drug costs under Medicare. (Photo by Patrick T. Fallon / AFP via Getty Images) The U.S. plans to negotiate the prices of 15 more medications covered by Medicare, including two of Eli Lilly's top-selling drugs - though there were few surprises. The Centers for Medicare and Medicaid Services on Tuesday announced the third round of drugs included in the Medicare Drug Price Negotiation Program. "CMS is taking strong action to target the most expensive drugs in Medicare, negotiate fair prices, and make sure the system works for patients - not special interests," CMS Administrator Mehmet Oz said in a statement. This time, the program includes, for the first time, medicines covered by Part B, which are drugs administered by clinicians in outpatient settings, in addition to those covered by Medicare Part D, which handles medications you can pick up at a pharmacy. It's also renegotiating the price of Boehringer Ingelheim's Type 2 diabetes treatment Tradjenta, which was already selected for negotiation for 2027 - that's the first time the CMS has said it's renegotiating the price of a drug it already selected. The Part B drugs include AbbVie's (ABBV) neuromuscular-blocking drug Botox, which is prescribed for clinical reasons such as migraines; Bristol-Myers Squibb's (BMY) rheumatoid arthritis drug Orencia; Pfizer's (PFE) autoimmune drug Xeljanz and Xeljanz XR; and Takeda's (JP:4502) ulcerative colitis drug Entyvio. The Part D list includes Lilly's (LLY) GLP-1 for Type 2 diabetes Trulicity and breast-cancer drug Verzenio. Those drugs were the No. 2 and No. 3 top-selling drugs for Lilly in 2024. It also has Eisai's (JP:4523) Lenvima for thyroid cancer; Gilead Sciences' (GILD) HIV medication Biktarvy; GSK's (GSK) COPD treatment Anoro Ellipta; Johnson & Johnson's (JNJ) prostate-cancer drug Erleada; Novartis's (NVS) plaque-psoriasis drug Cosentyx and breast-cancer treatment Kisqali; Otsuka (JP:4768) and Lundbeck's (DK:HLUN.B) antipsychotic Rexulti; Roche (CH:ROG) and Novartis's Xolair for allergic reactions; and UCB's (BE:UCB) Cimzia, which is used to treat several autoimmune conditions. Analysts described the selected drugs as business as usual for most. With the exception of therapeutic Botox, "most of the products selected were already forecast to see modest growth to more meaningful declines," according to a note by Cantor Fitzgerald analysts. The 15 drugs account for $27 billion in drug spending under Medicare. The pharmaceutical companies that market these medications decide in February whether to participate in the program. (All have done that so far.) The prices are negotiated over the year, and the new prices go into effect in 2028. The program, which was created by the 2022 Inflation Reduction Act under then-President Joe Biden, seeks to lower the cost of Medicare drug spending. "The rates for drugs selected for the second round of negotiations were a bit tougher than the Biden Administration's negotiations in the first year, and we may see that again with this round of negotiations," Raymond James analyst Chris Meekins told investors on Wednesday. -Jaimy Lee This content was created by MarketWatch, which is operated by Dow Jones & Co. MarketWatch is published independently from Dow Jones Newswires and The Wall Street Journal. (END) Dow Jones Newswires 01-28-26 0807ET