The federal government is scheduled to reveal the first 10 medications up for the first-ever price discussions in Medicare in less than three months.
The pharmaceutical industry and those who support them seek to prevent that.
Lawsuits Challenge Medicare Medication Price Negotiations
Merck and the US Chamber of Commerce both filed lawsuits against the government this week, alleging that Medicare medication price negotiations violate the Constitution in a number of different ways.
The Biden administration disputes those assertions, arguing that Medicare is free to negotiate drug rates in accordance with the Constitution.
And according to legal experts, it will be difficult for the challengers to succeed in their suits.
The Inflation Reduction Act, which was approved by Congress’s Democrats last summer, achieved the party’s long-standing objective of enabling Medicare to bargain down the costs of some pricey medications obtained from pharmacies and administered in doctors’ offices.
Although the clause was not as extensive as some Democrats had hoped, it does allow Medicare to utilize its size to negotiate lower drug prices for the federal government and elderly citizens.
However, it is unknown how many beneficiaries will benefit from these negotiations in any given year.
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Criteria for Prescription Drugs Open to Negotiation
Ten prescription medications’ pricing for 2026, fifteen more for 2027, and ten more for 2028 are all subject to negotiation by the secretary of health and human services.
For 2029 and after, the number grows to 20 medications annually. Only drugs that have been available without competition for a number of years are eligible.
The Centers for Medicare and Medicaid Services will only choose Part D medications that are bought from pharmacies during the first two years of negotiations.
For 2028, it will also include prescription medications delivered by doctors under Part B. On September 1, it will publish the list of the first ten Part D medications chosen for negotiation.
Their producers will then have one month to determine whether or not to enter into participation agreements.
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