Medicare drug pricing negotiations — the first of their kind in the United States, passed under President Joe Biden — face an uncertain future in the new Trump administration.
The deliberations, as mandated by the Inflation Reduction Act of 2022, are intended to help people on Medicare afford their medications by allowing the government program to negotiate prices directly with drug manufacturers.
Last year, Medicare reached agreements to lower the prices of 10 drugs. The program should release by February 1 a list of 15 additional prescription drugs selected for the next round of negotiations. Semaglutide, the active ingredient in Ozempic and Wegovy, could be at the top of the list of medications. Other possible candidates include the breast cancer drug Ibrance, Trelegy, an asthma treatment, and Tradjenta, for diabetes.
While ending the program won’t be easy because it requires congressional approval, recent moves by allies of newly elected President Donald Trump may not bode well for the program’s future, said Juliette Cubanski, deputy director of the Medicare Policy Program at KFF, a nonprofit organization. that conducts research on health policy issues.
“We know that some Republicans in the last Congress introduced legislation to repeal the entire Inflation Reduction Act and eliminate the drug price negotiation program,” Cubanski said. “Wiping the bargaining program off the books was also addressed in Project 2025 and other Republican proposals we’ve seen in the past.
“I think there is certainly ideological support from the Trump administration, or allies of the new Trump administration, for abolishing the negotiating program,” she added.
A political risk
In August, the Biden administration announced lower prices for the 10 most expensive prescription drugs covered by Medicare, including Eliquis, a blood thinner from Bristol Myers Squibb; Imbruvica, a blood cancer treatment from AbbVie and Johnson & Johnson; and NovoLog, a diabetes drug from Novo Nordisk. The new prices will come into effect in 2026.
In 2027, negotiated prices will go into effect for an additional 15 drugs, followed by another 15 drugs in 2028 and another 20 in each subsequent year if the program remains in effect.
The program is expected to save the government and taxpayers billions. The pharmaceutical industry has fiercely contested the program through lawsuits, but has so far been unsuccessful.
Trump and prominent members of his health care team, such as Robert F. Kennedy Jr., his pick to lead the Department of Health and Human Services, have remained mum on whether they plan to support the negotiations or will try to abandon them to come.
A spokesperson for Trump’s transition team did not respond to multiple requests for comment.
Andrew Mulcahy, a health economist at the Rand Corporation who has advised the Biden administration on the negotiating program, said Trump may want to do away with it simply because it is one of Biden’s signature legislative achievements.
He noted that during his first term, Trump also tried to repeal the Affordable Care Act, one of Democratic former President Barack Obama’s historic achievements. Trump continues to threaten to repeal the health care law.
Eliminating Medicare negotiations would be politically risky for Trump, Mulcahy said.
A recent KFF survey found that a quarter of adults say they have trouble paying for their medications. Three in 10 say they haven’t taken their medicine as prescribed because of the cost.
Republicans have not said how they would replace the policy, Mulcahy said.
“The Trump administration coming in and saying, ‘Oh, you know what, we’re actually just going to let them stay at the high prices they paid for’ is a tough, tough option for them,” Mulcahy said.
A win-win situation for Trump
In a possible twist, preserving Medicare provision could actually be a political victory for Trump, especially if Ozempic makes the list this year, Cubanski said.
Trump could “declare victory for patients over Ozempic’s high price by cutting a raw deal and negotiating a steep discount,” she said.
Trump tried to lower drug prices during his first term, said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University.
“Supporting negotiations for a lower price for Ozempic would be a win-win for Trump,” Gostin said. “First of all, the drug is extremely popular and is especially needed among his supporters. Rural residents tend to have higher rates of obesity and diabetes, so making weight loss medications more affordable would receive widespread support.”
Moreover, Congress has already passed the law, meaning it could be easier for Trump to expand it, he said.
“There are compelling political reasons to support drug price negotiations,” Gostin said.
This article was originally published on NBCNews.com
