Inside the DIY Ozempic boom
Americans are cooking their own Ozempic. This is why we should be concerned.
The Centers for Medicare and Medicaid Services announced Nov. 25 that Medicaid recipients will receive reduced payments for 15 prescription drugs, including popular weight-loss drugs Ozempic and Wegovy, as well as asthma medications and chemotherapy drugs.
The changes will take effect in 2027.
In 2024, negotiated drugs accounted for about $42.5 billion of prescription spending for the approximately 5.3 million people covered by Medicare Part D, according to a news release. A fact sheet published with the announcement states that once the new pricing kicks in, Medicare will save about $12 billion and Part D beneficiaries will save about $685 million in out-of-pocket costs.
The lower prices were negotiated through the Medicare Drug Price Negotiation Program, created by the Inflation Control Act of 2022, passed under the Biden administration. The Trump administration had previously announced lower drug prices through executive orders and negotiations with drug manufacturers.
The bill directs the Secretary of Health to negotiate prices for 10 drugs that go into effect in 2026, 15 drugs that go into effect in 2027, and 15 more drugs that go into effect in 2028. Pricing for 20 more drugs is scheduled to take effect in 2029, according to a parliamentary analysis. Drugs negotiated for price reductions in 2027 and 2028 only apply to drugs under Medicare Part D.
Stacey Duseczina, a health policy professor at Vanderbilt University, told NBC News that the negotiated price “seems very reasonable,” but noted that the $274 price tag for Ozempic and Wegoby is higher than the $250 price the Trump administration negotiated in its contract with manufacturer Novo Nordisk.
“We should have made that deal for the benefit of taxpayers and Medicare beneficiaries,” Dusetsyna said.
Savings exceed negotiations in 2024
The 36% savings expected in 2027 are better than the 22% savings in net spending that Medicare achieved in the first round of price negotiations for 10 drugs last year, according to Goldman Sachs estimates.
CMS Administrator Mehmet Oz said in a news release that the new negotiations are “in stark contrast” to those that took place in 2024. “By using the same process in a bolder direction, we achieved significantly better outcomes for taxpayers and seniors in the Medicare Part D program,” Oz said.
Drugs negotiated under the Biden administration, such as Pfizer and Bristol-Myers Squibb’s blood thinner Eliquis and Amgen’s arthritis drug Enbrel, still cost on average more than double, and in some cases five times, what drug companies agreed to in other high-income countries.
The biggest blows in the Medicare negotiations were AstraZeneca’s leukemia drug Calquence, Boehringer’s lung drug Ofev, and Pfizer’s breast cancer drug Ibrance. Each was sold more than $4,000 off the estimated net price.
William Padula, a professor of pharmaceutical and health economics at the University of Southern California, told Reuters that while “they’re getting more efficient with their methodology,” this latest new product line is likely to have “more wiggle room” in price.
Additional drugs to be negotiated this year include GSK’s asthma and COPD inhaler Trelegy Ellipta, priced at $175, and AbbVie’s irritable bowel syndrome treatment Linzess, priced at $136.
List of medicines for which you can check discounted prices
Below are the costs for 30 days of the 15 medications included in the negotiation.
- Ozempic, Libersus, Wigovi: Negotiated price $274, list price $959
- Trelegy Ellipta: Negotiated price $175, list price $654
- Standi: Negotiated price $7,004, list price $13,480
- Slowness: Negotiated price $8,650, list price $21,744
- off: Negotiated price $6,350, list price $12,622
- Ibrance: Negotiated price $7,871, list price $15,741
- Lindseth: Negotiated price $136, list price $539
- Calculation: Negotiated price $8,600, list price $14,228
- Oosted and Oosted XR: Negotiated price $4,093, list price $6,623
- Breo Ellipta: Negotiated price $67, list price $397
- Xifaxan: Negotiated price $1,000, list price $2,696
- Vreis: Negotiated price $770, list price $1,376
- tradition: Negotiated price $78, list price $488
- Janumet and Janumet XR: Negotiated price $80, list price $526
- Otezla: Negotiated price $1,650, list price $4,722
Contributed by: Reuters
