The U.S. Department of Health and Human Services (HHS) released on Aug. 29 the first 10 medications to be price negotiated by Medicare in accordance with policies included in the Inflation Reduction Act of 2022. As the Centers for Medicare and Medicaid Services (CMS) has outlined, the next step will be for the agency to negotiate with the applicable drug manufacturers starting later this year.

Following the negotiations, CMS will publicly release any agreed upon prices for the selected drugs by Sept. 1, 2024. The negotiated prices will go into effect starting Jan. 1, 2026. In future years, CMS will select for negotiation up to 15 more drugs covered under Part D for 2027, up to 15 more drugs for 2028 (including drugs covered under Part B or Part D), and up to 20 more drugs for each year after.

Seven out of the 10 initial drugs listed are either cardiovascular or diabetes related, and patients will likely ask cardiovascular clinicians and practices about this process due to substantial media coverage. Key takeaways to keep in mind include:

• Any price changes for these drugs will be implemented on Jan. 1, 2026.
• The overall cost impact of these negotiated prices is yet to be determined.
• Any patient out-of-pocket cost changes will vary based on the specific Part D plans and benefit design.
• The implementation of this program could be delayed due to numerous lawsuits filed against HHS.

Clinicians can find the full list of medications up for price negotiation here. ACC Advocacy staff are continuing to monitor this program and will provide additional updates as more information becomes available.

Clinical Topics: Cardiovascular Care Team

Keywords: ACC Advocacy, United States, Centers for Medicare and Medicaid Services, U.S., Health Expenditures, Negotiating, Policy, Medicaid, Diabetes Mellitus

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