This content originally appeared on diaTribe. Republished with permission.
By April Hopcroft
Key Takeaways:
Reduced prices for 10 drugs covered under Medicare, including Jardiance, Farxiga, Januvia, rapid-acting insulin NovoLog and ultra-rapid Fiasp, are scheduled to go into effect in 2026.
The list of lower-priced medications includes three medications that protect cardiovascular health.
People on Medicare paid $3.4 billion in total out-of-pocket costs in 2022 for the drugs on the list. The new prices will save some people hundreds of dollars per month.
The U.S. Centers for Medicare and Medicaid Services (CMS) announced new, substantially lower prices to take effect in 2026 for the first round of drugs eligible for price negotiations. Among them are a handful of drugs approved for diabetes, heart failure, and kidney disease.
This is the latest victory in medication access thanks to the Inflation Reduction Act. The Inflation Reduction Act aims to reduce healthcare costs through insulin price caps, caps on costs for other drugs, penalties for drug makers that raise prices, and benefits for low-income people.
Which diabetes drugs saw price reductions?
The list of 10 drugs includes the following diabetes medications:
Drug name
Medication class
Approved for
Negotiated Price for 30-day supply in 2026
Jardiance
SGLT-2 inhibitor
Diabetes and heart failure
$197 (current price $573)
Farxiga
SGLT-2 inhibitor
Diabetes, heart failure, and chronic kidney disease
$178.50 (current price $556)
Januvia
DPP-4 inhibitor
Diabetes
$113 (current price $527)
Fiasp FlexTouch
Fiasp PenFill
NovoLog
FlexPen
NovoLog PenFill
Rapid-acting (NovoLog) and ultra-rapid-acting (Fiasp) insulin
Diabetes
$119 (current price $495)
The list also includes three agents for broader cardiovascular health:
Entresto, approved for heart failure. $295 (current price $628)
Xarelto, a blood thinner used to prevent and treat blood clots. It also reduces the risk of clots for people with coronary or peripheral artery disease (PAD). $197 (current price $517)
Eliquis, a blood thinner approved for the prevention and treatment of blood clots (current price $628).
How were these drugs chosen for negotiation?
The U.S. Health Secretary selected 10 drugs from a list of medications with the highest total Medicare Part D spending.
Medicare Part D refers to prescription drug coverage. It includes several diabetes medications and insulins – including Lantus, Jardiance, NovoLog, and Trulicity – that are also on the list of most expensive drugs overall.
The 10 medicines chosen were used by more than 8 million people covered by Medicare Part D in the past year, according to CMS, which amounted to $50.5 billion in total prescription drug costs.
Will other drug prices be negotiated?
Yes — Medicare will negotiate 15 more Part D drugs in 2025 to take effect in 2027 and 15 drugs under Part D to go into effect in 2028. An additional 20 drugs will see lower prices in 2029.
How large of an impact will negotiated prices have?
President Joe Biden said that once the negotiated prices take effect, up to 9 million older adults may see lower drug prices. This is especially important because seniors currently pay up to $6,500 in out-of-pocket costs each year for these medications.
In 2022, Medicare beneficiaries paid $3.4 billion in total out-of-pocket costs for the 10 drugs that will see negotiated lower prices in 2026. Negotiated prices will range from 25-60 percent off a drug’s list price. Discounts may vary based on how long a medication has been on the market.
What does this announcement mean for people with diabetes?
More affordable drugs for people with diabetes on Medicare is likely to lead to more consistent use of the drugs and better glycemic control.
Jardiance and Farxiga also provide cardiovascular protection, so greater access to these drugs can ensure improved heart health.
“Making diabetes care more affordable is a top priority for the American Diabetes Association. We commend CMS for taking action to bring down costs of life-saving drugs, including those for Medicare beneficiaries living with prediabetes and diabetes,” said Lisa Murdock, chief advocacy officer at the American Diabetes Association (ADA).
How might price negotiations affect diabetes research and innovation?
One unintended effect of these price reductions is that they may potentially slow down pharmaceutical research. When lower prices go into effect, drug companies will likely make less money on these drugs. If drug companies bring in less money overall, they may need to make budget cuts to certain parts of their business, such as clinical trials.
Since research is a key part of improving diabetes care, it is important to continue to advocate for investment into clinical trials.
“Equally as important is the ongoing support of innovative research and development to find a cure for diabetes. We look forward to continuing to work with CMS and others to have a positive impact in the diabetes community we serve,” Murdock said.
Learn more about access to diabetes medications and insulin:
Medicare Can Now Cover Wegovy for Obesity and Heart Disease
People on Medicare Can Now Access Afrezza and CGM Devices
Medicare Covers FreeStyle Libre 3 CGM