Biden Admin Unveils Lower Medicare Drug Prices

New prices are expected to save millions of seniors and other Medicare beneficiaries $1.5 billion in out-of-pocket costs in the first year of the program alone

For far too long, Americans have paid more for their prescription drugs than any developed nation. Today, the Biden-Harris Administration is delivering on its promise to lower out-of-pocket drug costs for seniors and save money for Americans. That's because Medicare has the power to negotiate prescription drug prices for the first time in history thanks to the Inflation Reduction Act, which was signed into law by President Biden with Vice President Harris casting the tie-breaking vote. Because Medicare is now able to negotiate lower prescription drug prices for seniors and people with disabilities, American taxpayers are expected to save $6 billion on prescription drug costs, and people enrolled in Medicare are expected to save $1.5 billion in out-of-pocket costs in 2026 alone. President Biden and Vice President Harris took on Big Pharma and won, and now millions of seniors and others on Medicare will soon see their drug costs go down on some of the most common and expensive prescription drugs that treat heart disease, cancer, diabetes, blood clots, and more.

HHS Announces Negotiated Prices for Medicare Drugs

HHS has reached agreements with all participating manufacturers on new negotiated, lower drug prices for the first 10 drugs selected for the Medicare drug price negotiation program. After manufacturers have steadily increased the list prices of all 10 of these drugs since they went on the market, these new prices will cut the list price of these drugs between 38 and 79 percent.

The new prices will go into effect for people with Medicare Part D prescription drug coverage in 2026:

Source: CMS, https://www.cms.gov/files/document/fact-sheet-negotiated-prices-initial-price-applicability-year-2026.pdf

These ten drugs are among those with highest total spending in Medicare Part D. If the negotiated prices had been in effect during 2023, Medicare would have saved an estimated $6 billion. When the negotiated prices go into effect in 2026, people enrolled in Medicare Part D are estimated to save $1.5 billion in out-of-pocket costs.

Millions of Part D enrollees that depend on these treatments to treat life-threatening conditions including diabetes, heart failure, and cancer are also expected to see lower out-of-pocket costs for these drugs. For example, a Medicare enrollee who takes Stelara for their arthritis and pays $3,459 on their drug today for a 30-day supply would pay only $1,174 in 2026. Many seniors and people with disabilities on Medicare who take these drugs will also benefit from the Inflation Reduction Act's $2,000 cap on out-of-pocket spending, which will be fully in effect in 2025, saving 19 million beneficiaries an average of $400 per year, in addition to these savings from the negotiated drug prices.

More drugs will be selected each year as part of Medicare's drug price negotiation program. Medicare will select up to 15 additional drugs covered under Part D for negotiation in 2025, up to an additional 15 Part B and D drugs in 2026, and up to 20 drugs every year after that.

Building on Progress Lowering Health Care Costs

Every day, millions of Americans are saving money on health care costs because of the Biden-Harris Administration's actions.

• People with Medicare are saving an average of $70 in out-of-pocket costs on vaccines like shingles and Tdap because President Biden's Inflation Reduction Act made recommended vaccines free for beneficiaries, including the 10.3 million enrollees who received a free vaccine in 2023.
• All 3.4 million Medicare Part D enrollees who filled an insulin prescription in 2023 had their insulin costs capped at $35 per month, saving some seniors hundreds of dollars for a month's supply.
• Some seniors and other Medicare beneficiaries taking drugs covered under Part B for which manufacturers have hiked prices faster than inflation are saving up to $4,593 in lower coinsurance this quarter thanks to the new Medicare inflation rebates.
• Starting this year, Part D enrollees no longer pay 5% co-insurance when they reach the catastrophic phase of their benefit and have their out-of-pocket drug costs capped at about $3,500. In just the first quarter of 2024, over 260,000 people benefited from this cap.
• Millions of American are saving an average of about $800 per year on health insurance premiums because of savings from the American Rescue Plan that the Inflation Reduction Act extended, helping drive the nation's uninsured rate to historic lows under the Biden-Harris Administration.

Check out the Biden-Harris Administration's Savings Explorer to see how some of the Administration's policies are helping Americans save money on annual expenses - from health care to junk fees, grocery costs and more.

Continuing to Lower Prescription Drug Costs

People with Medicare will continue to see their prescription drug costs go down as more provisions of the Inflation Reduction Act go into effect next year. Nearly 19 million seniors and other Part D beneficiaries are projected to save $400 per year on prescription drugs when the out-of-pocket cap drops to $2,000 in 2025, and 1.9 million enrollees with the highest drug costs will save an average of $2,500 per year. And the lower prices negotiated for the high-spend drugs announced today will go into effect in 2026.

The President's Budget for Fiscal Year 2025 builds on this success by significantly increasing the pace of negotiation, bringing more drugs into negotiation sooner after they launch, expanding the $2,000 out-of-pocket prescription drug cost cap beyond Medicare and into the commercial market, and other steps to build on the Inflation Reduction Act drug provisions. The Budget also includes proposals to curb inflation in prescription drug prices and extends the $35 cost-sharing cap for monthly prescriptions of insulin to the commercial market to lower drug costs for all Americans.