Medicare drug value negotiation is right here. The utmost truthful costs (MFP) set by Medicare result in reductions between 38% and 79%. In reality, the actual reductions are bigger because the figures listed within the desk under are reductions off of 2023 costs (reasonably than 2024 costs).
How did the negotiation course of work? CMS’s truth sheet described the method as follows:
CMS held three conferences with every collaborating drug firm to debate the affords and counteroffers, focus on proof, and try to arrive at a mutually acceptable value for the drug. Throughout the course of the negotiation course of, CMS revised its affords for every of the medicine upward in response to those discussions. Likewise, many drug firms revised their counteroffers for his or her medicine downward, primarily based on the discussions with CMS. For 5 of the chosen medicine, this means of exchanging revised affords and counteroffers resulted in CMS and the drug firm reaching an settlement on a negotiated value for the drug in affiliation with a negotiation assembly. In 4 of those instances, CMS accepted a revised counteroffer proposed by the drug firm. For the remaining 5 chosen medicine, CMS despatched a written last provide to these drug firms, in line with the method described in its steerage, and in every occasion, the drug firm accepted CMS’s provide on or earlier than the statutory deadline.
However how precisely did CMS arrive at these costs? This isn’t clear. In reality, CMS stated it gained’t make public a proof of the agreed-upon negotiated costs till March 2025.
Extra particulars on the MFP negotiation timeline is under.
What info and sources have been utilized in setting the MFP? Related info included:
…producer=submitted information on analysis and improvement prices, prior federal monetary help, unit prices of manufacturing and distribution, market/income/gross sales information, and knowledge on patents, FDA exclusivities, and FDA purposes and approvals. For the components listed at part 1194(e)(2) associated to proof about various remedies (together with therapeutic advances, prescribing info, comparative effectiveness, and unmet medical want), CMS thought of info from all kinds of sources, together with: info submitted by collaborating drug firms, individuals with Medicare, educational specialists, clinicians, caregivers, and different events…; info offered on the Affected person-Centered Listening Periods…; info shared by collaborating drug firms throughout conferences with CMS; and knowledge CMS recognized from its personal literature searches, together with from medical tips and revealed research.
The negotiated costs shall be efficient January 1, 2026.
