Federal Policy
Second Round of Medicare Drug Price Negotiations Takes Effect Jan. 1
Becker's Hospital Review outlines six things to know as Medicare's negotiated prices for 15 more Part D drugs, including Ozempic, Wegovy and Rybelsus, take effect January 1, joining the first round of 10 drugs already negotiated. Discounts range from 38% to 85% below 2024 list prices, and CMS estimates $685 million in enrollee savings in 2027 across 5.3 million beneficiaries. The same date triggers a separate 340B rebate-only pricing pilot for several overlapping drugs, which the American Hospital Association and four hospitals sued October 9 to block; a bipartisan House bill would delay that pilot through 2028. Stelara exits the negotiation program due to biosimilar competition, and a third round covering Part B drugs begins in 2028.
Why it mattersHospital pharmacies and health systems face a dual financial hit on January 1 if the 340B rebate pilot proceeds alongside negotiated prices, forcing them to front wholesale acquisition costs while awaiting manufacturer rebates on overlapping drugs.