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Ozempic and Wegovy, the blockbuster but costly GLP-1 drugs often used for weight loss, are among the 15 medications that will be subject to the next round of Medicare price negotiations, the Biden administration announced Friday.
But how much consumers will ultimately save depends on many factors, including the incoming Trump administration’s approach to the negotiation process and the type of Medicare drug coverage an enrollee has. Those not eligible for Medicare will not benefit directly.
The 15 drugs on the list were used by about 5.3 million Medicare enrollees and treat a variety of diseases, including asthma, cancer and diabetes. The negotiated prices won’t take effect until 2027.
Medicare spent $14.4 billion on Ozempic and Wegovy, as well as their sister medication Rybelsus, between November 2023 and October 2024. The medications, manufactured by Novo Nordisk and used to treat Type 2 diabetes and obesity, were used by nearly 2.3 million enrollees during that period. Wegovy has also been approved to treat cardiovascular disease.
The other drugs on the list include:
- Trelegy Ellipta, treats asthma
- Xtandi, treats prostate cancer
- Pomalyst, treats multiple myeloma, AIDS-related Kaposi sarcoma
- Ibrance, treats breast cancer
- Ofev, treats pulmonary fibrosis
- Linzess, treats chronic constipation, irritable bowel syndrome with constipation
- Calquence, treats leukemia, lymphoma
- Austedo, treats tardive dyskinesia, Huntington’s disease chorea
- Breo Ellipta, treats asthma, chronic obstructive pulmonary disease
- Tradjenta, treats Type 2 diabetes
- Xifaxan, treats hepatic encephalopathy, irritable bowel disease with diarrhea
- Vraylar, treats bipolar disorder, depression, schizophrenia
- Janumet, treats Type 2 diabetes
- Otezla, treats plaque psoriasis, psoriatic arthritis, certain oral ulcers
In total, Medicare spent about $41 billion on these medications, prior to rebates and discounts.
Novo Nordisk, which has filed a lawsuit against the Biden administration for including its insulin medications NovoLog and Fiasp in the first round of negotiations, said in a statement that it “remains opposed to government price setting through the IRA (Inflation Reduction Act) and has significant concerns about how the law is being implemented by this administration.”
“Even as our IRA lawsuit progresses, we remain committed to working with policymakers to advance solutions to ensure access and affordability for all patients,” the company said. “That is why we are deeply concerned about the price-setting process, which could 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.”
This story is developing and will be updated.
