The discounts should be compared against the drugs’ “ultimate net price” rather than their indicated list price to gauge the true impact of the negotiations, BMO Capital Markets analysts said.
Negotiations for the second cycle of the Inflation Reduction Act’s drug pricing program have wrapped up, and the Centers for Medicare and Medicaid Services on Tuesday released the final agreed-upon prices for the 15 covered medicines.
The discounts from list prices negotiated by CMS range from 38% for Teva Pharmaceuticals’ Huntington’s disease chorea therapy Austedo to 85% for Merck’s diabetes drug Janumet. Novo Nordisk’s Ozempic and Wegovy—arguably the most closely-watched drugs on this list—will sustain a 71% cost cut from their list price. The prices are set to take effect on Jan. 1, 2027.
Analyst responses to the list were subdued. The final negotiated prices, Guggenheim Partners wrote on Tuesday evening, turned out to be “roughly in line” with expectations. The firm pointed to “the extensive gross-to-net adjustments that the manufacturers are already providing on these drugs.”
BMO Capital Markets, for its part, wrote in a note to investors, “We reiterate that the important comparison remains the difference between the product’s newly discounted price and the product’s ultimate net price, including rebates,” instead of their list prices.
Guggenheim also pointed out that many of the drugs under negotiation have already peaked in sales or have biosimilar or generic competition expected soon. Therefore, “Any impact on sales from lower prices will only impact the companies for a handful of years.” The final maximum fair prices are listed below:
Tuesday’s pricing reveal comes amid the Trump administration’s push to lower drug costs in the U.S., for which it has launched several initiatives and struck a number of deals.
Earlier this month, for instance, the White House came to an agreement with Novo and fellow obesity leader Eli Lilly to offer their respective GLP-1 drugs through the government’s forthcoming direct-to-consumer (DTC) platform at a steep discount. Ozempic and Wegovy, which have list prices of $1,000 and $1,350 per month, respectively, will be available for $350 on TrumpRx, while Lilly’s Zepbound will drop from $1,068 per month to $346 on the DTC marketplace.
When the oral versions of their obesity drugs hit the market, the pharmas also promised to make their initial doses available for $150.
Aside from Novo and Lilly, other pharma companies have joined the TrumpRx program. Pfizer kicked off this trend in late September when it partnered with the government to offer some of its products—including the eczema drug Eucrisa and the migraine nasal spray Zavzpret—on the DTC site. AstraZeneca followed suit soon after and promised to put many of its inhalers on TrumpRx.
The centerpiece of the administration’s pricing push is its Most Favored Nation rule, announced in May. This executive order directs drug costs in the U.S. to be lowered to the same level as they are in similarly developed nations—a pricing philosophy that guides the other government initiatives, including its DTC program.
