Medicare Lists Cancer, Arthritis, HIV Drugs for Price Cuts

Medicare has listed cancer, arthritis, and HIV medications for its 2028 price negotiations, including Part B drugs administered in doctors' offices.

The Centers for Medicare & Medicaid Services (CMS) has published its latest list of prescription drugs selected for Medicare price negotiations, targeting treatments for cancer, arthritis, and HIV, among other conditions, with new prices set to take effect in 2028. This round notably expands to include high-cost "Part B drugs" that are administered by physicians in clinical settings, such as infusion therapies, marking a significant broadening of the Inflation Reduction Act's cost-control program.

The list includes several blockbuster medications, though analysts note that many of the selected drugs now draw a limited share of their total revenue directly from Medicare, due in part to earlier shifts in manufacturer pricing and patient assistance strategies in anticipation of the law. CMS will now enter direct negotiations with the manufacturers of these drugs over the coming months to establish a "maximum fair price."

"The inclusion of physician-administered drugs is a critical step in ensuring Medicare negotiates prices across the full spectrum of medicines seniors rely on," a CMS official stated. However, a pharmaceutical industry analyst observed, "The revenue impact on companies from this specific list may be muted, reflecting how the market has already adjusted to the policy's shadow."

This action represents the continued implementation of the Inflation Reduction Act's drug pricing provisions, a centerpiece of the administration's efforts to lower healthcare costs. It follows the first round of negotiations for 2026 and comes amid ongoing legal challenges from the pharmaceutical industry, which argue the policy is unconstitutional.

The negotiated prices for these medications will be announced by September 2024 and go into effect in January 2028. CMS officials have indicated that further guidance and updates on the negotiation process for these Part B and Part D drugs will be provided throughout the year.