The Facilities for Medicare and Medicaid Providers (CMS) has included Ozempic among the many subsequent 15 medication chosen for Medicare negotiation.
CMS listed Ozempic, Rybelsus and Wegovy — all types of semaglutide — on the high of the checklist of medicine for which Medicare will the negotiate the worth of in 2025. The checklist value for a one-month provide of Ozempic prices near $1,000 with out insurance coverage or producer coupons.
In response to CMS information, Medicare Half D spending on Ozempic was greater than $4.6 billion in 2022.
Ozempic has turn out to be emblematic of the explosive enthusiasm for GLP-1 medicines within the U.S. Danish pharmaceutical large Novo Nordisk is the producer of Ozemipc. Its diabetes treatment NovoLog was among the many first 10 medication chosen for Medicare negotiation.
The corporate filed a lawsuit searching for to cease the Medicare negotiation course of shortly after NovoLog was named, with a federal choose ruling towards the corporate’s arguments final 12 months.
“Novo Nordisk remains opposed to government price setting through the IRA and has significant concerns about how the law is being implemented by this administration, including aggregating multiple products that individually would not meet the requirements of the statute,” a Novo Nordisk spokesperson mentioned in an announcement.
“Even as our IRA lawsuit progresses, we remain committed to working with policymakers to advance solutions to ensure access and affordability for all patients,” they added. “That is why we are deeply concerned about the price-setting process, which could negatively impact patients’ ability to access their medicines and threatens to stifle future scientific development of life-changing medicines for chronic diseases in which there is a real unmet need.”
Semaglutide’s choice was based mostly on a set of standards within the Inflation Discount Act. The drug needs to be over seven years previous; Ozempic simply meets this requirement given its approval in December 2017.
A drug additionally should not have any generic or biosimilars available on the market if chosen for Medicare negotiation. Although compounded variations of semaglutide have proliferated lately, these merchandise aren’t thought-about generic variations of semaglutide and aren’t authorized by the Meals and Drug Administration (FDA).
The primary spherical of Medicare negotiations yielded reductions on medication starting from 40 to 80 %, together with 76 % off the checklist value for NovoLog.
