How the first 10 drugs set for Medicare negotiations were chosen

How the first 10 drugs set for Medicare negotiations were chosen

Aug 29, 2023 by Health Care - Politico

Key Facts

  • And there are three exemptions from being included on the list for which drug companies can apply to the CMS.
  • For instance, a small molecule drug, which is a product in pill form such as an aspirin, must have been on the market for nine or more years to be negotiation eligible.
    • For the highest annual expenditures for Medicare Part D, which is the program’s prescription drug benefit that covers drugs obtained at the pharmacy counter, CMS considered the 50 drugs that met this parameter on expenditures accounting from June 1, 2022, through May 31, 2023.
  • They are: Small biotechs that manufacture one drug that may be expensive but treats a relatively small number of Americans Biologic drugs that have a high likelihood of getting biosimilar competition within two years of the list or any addition to the list being published This is the start of the negotiation process, and drug companies have until Oct. 1 to decide whether to enter into talks with CMS.

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