JAN 19, 2023
CMS Announces Timeline for Negotiated Medicare Drug Pricing
Last week, the Centers for Medicare & Medicaid Services (CMS) announced a timeline to implement negotiated Medicare drug pricing that would affect costs starting in 2026.
The Inflation Reduction Act, which was signed into law last summer, give Medicare authority to negotiate drug prices for some of the most expensive drugs.
- By Sept. 1, the agency will publish the first 10 Medicare Part D drugs selected for negotiation.
- The negotiated maximum fair prices for these drugs will be announced by Sept. 1, 2024.
- Prices will be in effect starting Jan. 1, 2026.
- CMS will select for negotiation 15 more Part D drugs for 2027; 15 more Part B or Part D drugs for 2028; and 20 more Part B or Part D drugs for each year after that.
The Academy does not foresee a short-term effect on ophthalmology, as costs of ophthalmic biologics, like Lucentis (ranibizumab) and Eylea (aflibercept), are unlikely to be targets given provisions of the bill exempting drugs from negotiation that have existing or looming biosimilar competition.
The Academy will stay engaged on this issue and weigh in with CMS during any public comment period to underscore efforts to lower the cost of prescription drugs for patients should not have unintended financial impacts on physicians.