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Update on CMS Drug Negotiations

For those of you following the updates on the Part D negotiations, we're posting information via below for your reference.

CMS will send an initial offer for each selected drug for which the drug company is participating in the Negotiation Program with CMS’ proposal for the maximum fair price and a concise justification no later than today, February 1, 2024, and companies will have 30 days to respond to the initial offer by accepting the offer or providing a counteroffer, if desired.

The 10 Drugs under negotiation are:

  • Eliquis-a blood thinner from Bristol Myers Squibb and Pfizer

  • Xarelto-a blood thinner from Johnson & Johnson

  • Januvia-a diabetes drug from Merck

  • Jardiance-a diabetes drug from Boehringer Ingelheim and Eli Lilly

  • Enbrel-a rheumatoid arthritis drug from Amgen

  • Imbruvica-a drug for blood cancers from AbbVie and Johnson & Johnson

  • Farxiga-a drug for diabetes, heart failure and chronic kidney disease from AstraZeneca

  • Entresto-a heart failure drug from Novartis

  • Stelara-a drug for psoriasis and Crohn’s disease from Johnson & Johnson

  • Fiasp and NovoLog-diabetes drugs from Novo Nordisk

In developing an initial offer, CMS will consider evidence related to therapeutic alternatives as well as other factors, such as costs of research and development and production and distribution of the selected drug. If agreement on a maximum fair price is not reached through the initial offer or counteroffer, CMS will invite each participating drug company for up to three negotiation meetings during Spring and Summer 2024 before the negotiation period ends on August 1, 2024.

We'll continue to update as the information is released.

As always, if you have any questions give us a call.


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