The upcoming Trump administration casts doubt on the viability of Medicare’s medication pricing discussions, which were the first of their type in the US and were approved under President Joe Biden.
The purpose of the discussions, which are required under the Inflation Reduction Act of 2022, is to enable the government program to directly negotiate pricing with pharmaceutical companies in order to help Medicare beneficiaries afford their prescription drugs.
Medicare made deals to reduce the cost of several medications last year. By February 1st, the program is expected to publish a list of 15 more prescription medications chosen for the upcoming round of talks.
The active component of Ozempic and Wegovy, semaglutide, could be the most popular drug. Other potential choices include the asthma medication Trelegy, the diabetic medication Tradjenta, and the breast cancer medication Ibrance.
Juliette Cubanski, deputy director of the Medicare policy program at KFF, a nonprofit organization that studies health policy issues, said recent actions by President-elect Donald Trump’s allies may not bode well for the program’s future, even though terminating it won’t be simple because it requires authorization from Congress.
“We are aware that some Republicans introduced legislation in the most recent Congress to repeal the entire Inflation Reduction Act and eliminate the drug price negotiation program,” Cubanski stated. “Project 2025 and other Republican plans we’ve seen in the past also included wiping the negotiation program off the books.
“I believe that the Trump administration, or supporters of the incoming Trump administration, have ideological support for eliminating the negotiation program,” she continued.
A danger to politics
Eliquis, a blood thinner made by Bristol Myers Squibb; Imbruvica, a blood cancer treatment made by AbbVie and Johnson & Johnson; and NovoLog, a diabetes medication made by Novo Nordisk, were among the ten most expensive prescription drugs covered by Medicare that the Biden administration announced reduced prices for in August. In 2026, the new pricing are scheduled to go into effect.
Negotiated rates will be implemented for 15 further medications in 2027, 15 more in 2028, and 20 more in each of the following years if the program is maintained.
It is anticipated that the scheme would save billions of dollars for taxpayers and the government. Through litigation, the pharmaceutical industry has vigorously opposed the program, but to yet, it has not been successful.
Regarding whether they intend to support the discussions or attempt to terminate them, Trump and key members of his health team, including as Robert F. Kennedy Jr., his choice to head the Department of Health and Human Services, have been silent.
Several attempts for response from a Trump transition team representative were not answered.
Trump could seek to eliminate the negotiation program since it’s one of Biden’s most notable legislative accomplishments, according to Andrew Mulcahy, a health economist at the Rand Corporation who has counseled the Biden administration on the subject.
He pointed out that during his first time in office, Trump also attempted to repeal the Affordable Care Act, one of Democratic former President Barack Obama’s historic achievements. Trump’s threats to revoke the health care legislation have not stopped.
Mulcahy stated that Trump would be taking a political risk if he ended the Medicare discussions.
According to a recent KFF poll, 25% of respondents claim they have trouble paying for their prescription drugs. Three out of ten claim that the expense has prevented them from taking their medications as directed.
According to Mulcahy, Republicans have not stated how they will replace the policy.
Mulcahy stated that it is difficult for the Trump administration to come in and say, “Oh, you know what, we’re actually just going to let them stay at whatever high prices they were at.”
A win-win situation for Trump
If Ozempic is included on the list this year, it might be a political gain for Trump to preserve the Medicare provision, according to Cubanski.
Trump could “drive a hard bargain and negotiate a steep discount to declare victory for patients over the high price of Ozempic,” she suggested.
According to Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law, Trump attempted to reduce medicine costs during his first term.
“Trump would benefit from supporting negotiations for a lower price for Ozempic,” Gostin stated. First of all, the substance is very well-liked and necessary, especially for his base. Making weight reduction medications more accessible would be widely supported because overweight and diabetes are more common among rural inhabitants.
Furthermore, the legislation has already been enacted by Congress, which may make it simpler for Trump to expand it, he added.
“There are strong political arguments in favor of negotiating drug prices,” Gostin stated.
