Medicare’s groundbreaking drug price negotiations, a major provision of the Inflation Reduction Act of 2022, are facing an uncertain future with the incoming Trump administration. This historic policy, designed to make medications more affordable for seniors, allows Medicare to negotiate directly with pharmaceutical companies to lower prices for certain high-cost drugs.
Last year, Medicare successfully negotiated lower prices for 10 medications, with a new list of 15 drugs expected to be selected by February 1, 2024. Among the potential candidates for price negotiation is semaglutide—the active ingredient in popular weight-loss drugs like Ozempic and Wegovy. Other drugs under consideration include Ibrance, a breast cancer treatment, Trelegy for asthma, and Tradjenta, used for diabetes.
While the negotiations have already shown promise in lowering prescription costs, the future of this program is unclear, especially with key political figures like former President Donald Trump signaling potential opposition. During his previous administration, Trump attempted to repeal the Affordable Care Act—another signature piece of Democratic legislation—and some Republican leaders have already proposed repealing the entire Inflation Reduction Act.
Juliette Cubanski, deputy director of the Medicare Policy Program at the Kaiser Family Foundation, noted that many allies of the incoming Trump administration have expressed support for dismantling the drug price negotiation program. “This ideological opposition could spell trouble for the future of the program,” she said.
The Biden administration’s recent price cuts on some of the most expensive Medicare drugs, like Eliquis and NovoLog, are scheduled to take effect in 2026. In the years following, the program aims to negotiate lower prices for even more drugs, with the potential for significant savings for both the government and taxpayers. However, the pharmaceutical industry has fought the program with lawsuits, although these efforts have thus far been unsuccessful.
If Trump were to oppose the program, he could face political backlash. A recent KFF survey found that a quarter of adults struggle to afford their medications, and many have even skipped doses due to cost. Eliminating the Medicare negotiations could present a tough political challenge, especially since Republicans have not outlined a clear alternative policy.
“Getting rid of the program would be politically risky,” said Andrew Mulcahy, a health economist at the Rand Corporation. “It could be seen as ignoring the real struggles of people trying to afford their medications.”
Ironically, Trump could find political benefits in supporting the continuation of Medicare drug price negotiations, especially if Ozempic is included in the upcoming list of drugs. Ozempic has gained massive popularity, particularly among individuals with obesity or diabetes—a group that includes many of Trump’s supporters in rural America.
Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law, explained, “Supporting price negotiations for Ozempic would be a win-win for Trump. Not only is the drug immensely popular, but making it more affordable could resonate strongly with his base, who are often battling obesity and diabetes.”
Moreover, since the law has already passed, Trump could expand it to further benefit American patients, enhancing his political standing. “There are clear political reasons for Trump to back this policy,” Gostin added.
As the new administration takes shape, all eyes will be on how Medicare’s drug price negotiation program evolves. With the potential to make high-cost medications more accessible, the program could be a key issue in the upcoming political debates. For now, Americans are left wondering: Will Trump embrace this opportunity to improve healthcare affordability, or will he push to reverse one of Biden’s most significant legislative achievements?
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