CMS Advances Drug Price Negotiations

Mar 14, 2025, the Centers for Medicare and Medicaid (CMS) publicized the names of 15 prescription drugs to participate in the Drug Price Negotiation program, and Ozempic is one of them. This milestone marks a crucial step in the government’s efforts to make prescription medications more affordable for millions of Americans.

The negotiation process allows CMS to work directly with pharmaceutical companies to establish fair pricing for these high-cost drugs, with new negotiated prices set to take effect in 2027.

Full List of Included Prescription Drugs

This is the second round of Drug Price Negotiation for drugs covered under Medicare Part D. The 15 medications in mention treat conditions like diabetes, cancer, and respiratory diseases.

Here is the full list of participating manufacturers and their corresponding drugs:

Why This Is Important for Patients

Nowadays, Ozempic is a popular medication for diabetes and weight management, but the retail cost for just one 3mL pen is $997.58. Unfortunately, Medicare beneficiaries still experience exorbitant copayments, even with Part D coverage.

Prescription drug costs are a significant financial burden for many Americans, particularly seniors and individuals with chronic illnesses. By negotiating directly with drug manufacturers, CMS aims to make these essential medications more affordable for Medicare beneficiaries.

Next Steps in Drug Price Negotiations

Now that agreements are in place, CMS will move forward with direct discussions with manufacturers, as well as collect feedback from patients, caregivers, and medical professionals.

1. Engagement Meetings with Drug Companies
   • CMS invites manufacturers of the selected drugs to meetings where they will submit data regarding costs, pricing history, and other relevant factors.
2. Patient-Focused Roundtables
   • CMS hosts 15 roundtable discussions– one for each selected drug. These sessions allow patients and advocacy groups to share insights on how these medications impact their health and financial well-being.
3. Clinician Town Hall
   • A separate town hall event will be held to gather input from doctors, researchers, and other experts about the medical necessity and alternatives to these drugs.
4. Initial Price Offer & Negotiation
   • By June 1, 2025, CMS must present an initial offer for a maximum fair price for each selected drug.
   • Drug manufacturers have 30 days to accept or counter the offer.
5. Final Negotiation Meetings
   • If an agreement is not reached in the first round, CMS must conduct up to two additional meetings with manufacturers between Summer and Fall 2025.
   • The final deadline to reach a negotiated price is November 1, 2025.

Since negociations continue through 2025, patients and healthcare providers should stay informed about any updates from CMS. If all goes as planned, the new Medicare drug prices will take effect in 2027, potentially bringing much-needed relief to millions of Americans who rely on medications like Ozempic.

Frequently Asked Questions (FAQs)

What is the CMS Drug Price Negotiation Program?

The program allows Medicare to negotiate directly with drug manufacturers to lower the cost of certain high-priced medications.

When will the negotiated drug prices go into effect?

The new prices for the selected drugs, including Ozempic, take effect in 2027 if all goes well.

How were the 15 drugs selected for negotiation?

CMS identified medications that have high Medicare spending and are widely used by beneficiaries (such as Ozempic), prioritizing those with significant out-of-pocket costs.

Will this impact all Medicare beneficiaries?

Yes, once negotiations are finalized, all Medicare Part D beneficiaries could benefit from lower drug prices.

This groundbreaking step in Medicare Drug Price Negotiation could significantly impact millions of Americans by making medications like Ozempic more affordable. Stay tuned for more updates!

For help with Medicare plans – or any questions you may have about Medicare – contact AMAC’s Medicare Advisory Service at 1-855-611-4856 or request a quote here.