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EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
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EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more
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EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more -
Middle East & Africa
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more
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Key Context for CMS Prescription Drug Negotiations
Trends in Drug Spending and Patient Costs
Oct 10, 2024
On August 16, 2022, U.S. President Biden signed into law legislation that included provisions to lower healthcare costs for millions of Americans, known as the Inflation Reduction Act (IRA). The intentions of the new law’s drug pricing provisions are to make improvements to Medicare that will expand benefits, lower drug costs, keep prescription drug premiums stable, and improve the strength of the Medicare program. Along with various provisions to lower Medicare prescription drug costs, the law also provides the ability for the federal government to negotiate directly with drug manufacturers to lower the price of some of the highest-expenditure single-source brand name Medicare Part B and Part D drugs.
This research brief from the IQVIA Institute provides key data and context on net drug spending for the first set of drugs selected for negotiations by Centers for Medicare & Medicaid Services and how patient out-of-pocket costs may evolve for these drugs.
Key Findings:
- Accounting for rebates, discounts, and other payments from manufacturers across all payers and the supply chain, the estimated net price growth associated with the 10 drugs selected for government negotiation has generally been low or negative.
- In 2023, negative net price growth was seen for six out of nine products (Jardiance net price growth not available) and ranged from -2% to -44%.
- Six of the ten drugs subject to negotiation already are covered with fixed co-pays that will either not be affected by changes in prices or may potentially increase, depending on potential formulary changes, as plans could move the selected drugs to higher tiers, which raises patient copays and OOP costs.
- About 40% of Medicare Part D patients treated with the selected drugs are those with low-income subsidies, who already pay low, fixed cost-sharing. They are unlikely to see lower cost sharing as a result of government price negotiations.