White House targets blockbusters in Medicare’s price negotiation strategy

The Biden-Harris Administration has nominated 10 drugs for price negotiations directly with pharmaceutical giants after capping monthly insulin costs at $35.

Americans have historically paid more for prescription drugs than most other major economies. In a fact sheet, the White House highlighted that seniors paid $3.4 billion in out-of-pocket costs for these drugs just last year. Biden, like Trump before him, aim to bring prices more in line with those of other advanced nations.

This move is not isolated. The Biden Administration has implemented other cost-saving measures, such as reining in the cost of insulin and making some vaccines free for Medicare beneficiaries.

All of the 10 drugs on the list were blockbusters. Eight of the 10 were among the bestselling drugs of 2022. The remaining two are insulin formulations from Novo Nordisk: Fiasp and NovoLog.

The list of nominated drugs includes:

1. Eliquis (apixaban)

• 2022 Sales: $18,269,000,000
• Medicare Part D Costs (June 2022-May 2023): $16,482,621,000
• Common Indications: Prevention and treatment of blood clots

2. Stelara (ustekinumab)

• 2022 Sales: $9,723,000,000
• Medicare Part D Costs (June 2022-May 2023): $2,638,929,000
• Common Indications: Plaque psoriasis, psoriatic arthritis, ulcerative colitis, and Crohn’s disease

3. Imbruvica (ibrutinib)

• 2022 Sales: $8,352,000,000
• Medicare Part D Costs (June 2022-May 2023): $2,663,560,000
• Common Indications: Chronic lymphocytic leukemia/small lymphocytic lymphoma with 17p deletion, Waldenström’s macroglobulinemia

4. Xarelto (rivaroxaban)

• 2022 Sales: $7,460,849,000
• Medicare Part D Costs (June 2022-May 2023): $6,031,393,000
• Common Indications: Reducing risk of stroke in nonvalvular atrial fibrillation, deep vein thrombosis, pulmonary embolism, DVT prophylaxis following knee or hip replacement surgery

5. Januvia/Janumet (sitagliptin)

• 2022 Sales: $4,513,000,000
• Medicare Part D Costs (June 2022-May 2023): $4,087,081,000
• Common Indications: Type 2 diabetes

6. Farxiga (dapagliflozin)

• 2022 Sales: $4,386,000,000
• Medicare Part D Costs (June 2022-May 2023): $3,268,329,000
• Common Indications: Type 2 diabetes mellitus, heart failure

7. Enbrel (etanercept)

• 2022 Sales: $4,117,000,000
• Medicare Part D Costs (June 2022-May 2023): $2,791,105,000
• Common Indications: Plaque psoriasis, rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis, and ankylosing spondylitis

8. Entresto (sacubitril/valsartan)

• 2022 Sales: $4,644,000,000
• Medicare Part D Costs (June 2022-May 2023): $2,884,877,000
• Common Indications: Chronic heart failure and reduced ejection fraction

9 and 10. Fiasp and NovoLog–branded products

• 2022 Sales: Unavailable
• Medicare Part D Costs (June 2022-May 2023): $2,576,586,000
• Common Indications: Diabetes