CMS for Medicare Negotiations on Ozempic Pricing

The Centers for Medicare and Medicaid Services (CMS) has included Ozempic among the next 15 drugs selected for Medicare discussion.

CMS lists Ozempic, Rybelsus and Wegovy — all types of semaglutide — at the top of the list of drugs for which Medicare will set prices in 2025. The list price for a one-month supply of Ozempic is around $1,000 without insurance. or manufacturer’s coupons.

According to CMS data, Medicare Part D spending in 2022 was more than $4.6 billion in 2022.

Ozemipc has become a symbol of explosive enthusiasm for GLP-1 drugs in US Danish pharmaceutical giant Novo Nordisk, maker of Ozemipc. Its diabetes drug NovoLog was among the first 10 drugs selected for Medicare discussion.

The company filed a lawsuit to stop the Medicare negotiation process shortly after Novolog was named, after a federal judge ruled against the company’s argument last year.

“Novo Nordisk opposes government pricing through the IRA and has significant concerns about how the law is being implemented by this administration, including aggregating multiple products that would not individually meet the law’s requirements,” a Novo Nordisk spokesperson said. statement

“Even as our IRA case progresses, we remain committed to working with policymakers to advance solutions to ensure access and affordability for all patients,” they added. “That’s why we are deeply concerned about the pricing process, which could negatively impact patients’ ability to access their medicines and threatens to hinder the future scientific development of life-changing medicines for chronic diseases where there is truly unmet need.”

Selection of semaglutide was based on a set of deflation law criteria. The drug must be older than seven years; Ozempic only met this requirement given its approval in December 2017.

A drug must not have a generic or biosimilar on the market to be selected for Medicare negotiation. Although compounded versions of semaglutide have proliferated in recent years, these products are not considered generic versions of semaglutide and are not approved by the Food and Drug Administration (FDA).

The first round of Medicare negotiations offered discounts on drugs ranging from 40 to 80 percent, including a 76 percent discount off NovoLog’s list price.