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. 2025 Jan 7;333(1):85-87.
doi: 10.1001/jama.2024.22582.

Drug Prices Negotiated by Medicare vs US Net Prices and Prices in Other Countries

Olivier J Wouters  1 , Sean D Sullivan  1   2 , Emma M Cousin  2 , Nico Gabriel  3 , Irene Papanicolas  4 , Inmaculada Hernandez  3
Affiliations

Drug Prices Negotiated by Medicare vs US Net Prices and Prices in Other Countries

Olivier J Wouters et al. JAMA. .
No abstract available

Plain language summary

This study analyzes how prices negotiated by Medicare in the US compare with net prices before negotiation, ceiling prices, and list prices in 6 other high-income countries.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Wouters reported grants from the Commonwealth Fund during the conduct of the study and fees from the World Bank and World Health Organization outside the submitted work. Dr Sullivan reported grants from the Commonwealth Fund during the conduct of the study and consulting fees from Sanofi, Pfizer, Neurocrine, and Novo Nordisk for presentations on the Inflation Reduction Act outside the submitted work. Dr Papanicolas reported grants from the Health Foundation and Commonwealth Fund and fees from the World Health Organization, World Bank, and National Academies of Sciences, Engineering, and Medicine outside the submitted work. Dr Hernandez reported consulting fees from Pfizer and Bristol Myers Squibb for comparative effectiveness research on apixaban (unrelated to negotiations under the Inflation Reduction Act; relationship ended in 2022) outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Comparison of Treatment Costs Based on Prices Negotiated by Medicare, Initial Net Prices, and Ceiling Prices
Drugs are plotted on separate panels because of differences in price ranges and units. All amounts represent 30-day equivalents, except insulin aspart (expressed per 100 IU) and ibrutinib (expressed as weighted average price per tablet or capsule). The manufacturer of insulin aspart (NovoLog) reduced the product’s US list price in 2024, which is shown for comparison.
See this image and copyright information in PMC

References

    1. Seshamani M. Medicare Drug Price Negotiation Program. Centers for Medicare & Medicaid Services. Accessed August 4, 2024. https://www.cms.gov/files/document/revised-medicare-drug-price-negotiati...
    1. Sullivan SD, Wouters OJ, Cousin EM, Kirihennedige AS, Hernandez I. Integrating price benchmarks and comparative clinical effectiveness to inform the Medicare Drug Price Negotiation Program. Value Health. 2024;27(10):1348-1357. doi:10.1016/j.jval.2024.08.001 - DOI - PubMed
    1. Centers for Medicare & Medicaid Services . Medicare drug price negotiation. Accessed August 19, 2024. https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-p...
    1. Hernandez I, Cousin EM, Wouters OJ, Gabriel N, Cameron T, Sullivan SD. Price benchmarks of drugs selected for Medicare price negotiation and their therapeutic alternatives. J Manag Care Spec Pharm. 2024;30(8):762-772. doi:10.18553/jmcp.2024.24153 - DOI - PMC - PubMed
    1. Novo Nordisk to lower US prices of several pre-filled insulin pens and vials up to 75% for people living with diabetes in January 2024. News release. Novo Nordisk. March 14, 2023. Accessed August 20, 2024. https://www.novonordisk-us.com/media/news-archive/news-details.html?id=1...