Drugmakers Hike Prices on Hundreds of Brand-Name Drugs

Drugmakers Hike Prices on Hundreds of Brand-Name Drugs

Drugmakers raised the prices on 775 brand-name medicines, including Ozempic, through mid-January. Put together, the median is 4.5%, which is higher than the inflation rate.

However, the government will begin negotiations on 10 drugs covered by Medicare this week. But those new prices won’t go into effect until 2026.

Pfizer boosted the prices on “124 unique drug brands” and 22 “at its Hospira arm.” The drugmaker had the most increases in January for the second year in a row.

Ozempic went up 3.5% to $970 for a month’s supply. Mounjaro, another diabetes drug also used for weight loss, increased 4.5% to about $1,070 a month.

Here are a few of the drugs that increased by more than 4.5%:

• Trikafta, a cystic fibrosis treatment: 5.9% to $26,546 for 28 days.
• Dupixent, an anti-inflammatory drug: 6% to $3,800 for a month supply.
• Biktarvy, popular HIV treatment: 4.9% to $3,980.
• Skyrizi, a psoriasis therapy: 5.8% to $21,017 for a dose.
• Eliquis, a blood-thinner: 6% to $594 for a month supply.

Bristol attributed inflation, research investment, and innovation to the rise in prices:

The price paid to the company will “remain nearly flat” this year because of rebates and discounts, she said, and half of patients pay $40 or less a month.

Pfizer referred questions about Eliquis to Bristol. A company spokeswoman speaking generally said the amount of money Pfizer receives for its drugs and vaccines has dropped for the past five years because of climbing rebates and discounts to health insurers and pharmacy-benefit managers.

I remember those rebates and discounts when I took Humira and Simponi for rheumatoid arthritis. I couldn’t believe the amount for one dose, but when I signed up for the company’s savings program, it dropped to $5. I don’t remember the exact number because I haven’t taken those in a long time. I’m now on Rinvoq.

Starting Thursday, the Medicare program can negotiate drug prices due to President Joe Biden’s Inflation Reduction Act (IRA).

HHS published in October:

The new law requires the federal government to negotiate prices for selected high expenditure drugs covered under Medicare, and provides enhanced financial protection against out-of-pocket drug costs for Medicare beneficiaries. Other provisions require drug manufacturers to pay rebates to Medicare if they implement price increases for certain prescription drugs utilized by Medicare beneficiaries that exceed the rate of inflation. Manufacturers must pay rebates to Medicare if the Annual Manufacturer Price (AnMP) increases for certain covered Part D drugs and either the Average Sales Price (ASP) or Wholesale Acquisition Cost (WAC) increases for certain covered Part B drugs exceed the rate of inflation.

The first 10 drugs on the list, according to NBC News:

• Eliquis, a blood thinner from Bristol Myers Squibb and Pfizer;
• Xarelto, a blood thinner from Johnson & Johnson;
• Januvia, a diabetes drug from Merck;
• Jardiance, a diabetes drug from Boehringer Ingelheim and Eli Lilly;
• Enbrel, a rheumatoid arthritis drug from Amgen;
• Imbruvica, a drug for blood cancers from AbbVie and J&J;
• Farxiga, a drug for diabetes, heart failure and chronic kidney disease from AstraZeneca;
• Entresto, a heart failure drug from Novartis;
• Stelara, a drug for psoriasis and Crohn’s disease from J&J;
• Fiasp and NovoLog, diabetes drugs from Novo Nordisk.

These negotiations will go through August 1. The Biden admin will publish final prices on September 1.

But don’t expect relief right away. The prices won’t go into effect until 2026.

HHS also reminded off-site outpatient hospital facilities about the 340B Drug Pricing Program, which “requires drug manufacturers that participate in the Medicaid Program to offer certain outpatient drugs to ‘covered entities’ at discounted prices.”

HHS loosened many of its programs, including the 340B Program, due to COVID-19.

These facilities had to be:

• Listed as reimbursable on the hospital’s Medicare Cost Report prior to participating in the 340B Program
• Registered and listed in 340B Office of Pharmacy Affairs Information System (OPAIS) prior to participating in the 340B Program.

However, the expansion led to complications concerning compliance. The facilities have to fill out more forms for one of the two:

• Be listed on the hospital’s most recently filed Medicare Cost Report and registered in OPAIS by the next 340B Program quarterly registration period
• The covered entity must notify HRSA [Health Resources and Services Administration] within 90 days of the publication of the Notice that they have initiated the process of listing the offsite, outpatient facility on the hospital’s Medicare Cost Report and registering it in OPAIS [Office of Pharmacy Affairs].

But the 340B program helps rural hospitals survive. A great example is Golden Valley Memorial Healthcare in Missouri:

At GVMH, for example, 80% of our patients access their healthcare coverage through Medicare and Medicaid, with only 20% being covered by commercial insurance plans. While we are proud to provide care to beneficiaries of these vital safety-net programs, the fact is that Medicare and Medicaid reimburse hospitals at a lower rate than commercial insurers—and far less than the true cost of providing care and services. That makes the savings we see through the 340B program all the more essential in helping to sustain our operations.

“Without the 340B program, it would be extremely challenging, if not impossible, to continue providing oncology services at scale—which could force GVMH to reduce these services, threatening access to critical care for many rural cancer patients,” wrote Craig Thompson, CEO of GVMH.

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