Medicare Negotiated Drug Prices—Seniors and People with Disabilities Will Save Billions

Recently the White House announced new, lower Medicare prices for 10 blockbuster drugs—the result of months of negotiations between the government and pharmaceutical companies.

“News coverage of this landmark accomplishment focused on how these new lower prices will help out seniors, and it will, but it will also benefit those who have qualified for Social Security Disability,” observes Chicago disability attorney Tom Nash.

“While most people think of Medicare as a program for those over 65 years old, it also provides insurance protection for Americans with disabilities,” Nash explains.  “If Social Security says you are eligible to receive disability benefits under Social Security Disability Insurance (SSDI)—a program for individuals who have paid into the Social Security system—you will qualify for Medicare benefits (you must wait two years from your established date of entitlement to the cash disability benefit.)”

The negotiated prices, which take effect in 2026, are expected to save billions of dollars for Medicare, which is funded by taxpayers for those Americans who depend on these prescription drugs. The 10 medications which will have lowered prices are:

1. Eliquis, for preventing strokes and blood clots
2. Jardiance, for diabetes, heart failure and chronic kidney disease
3. Xarelto,for preventing strokes and blood clots
4. Januvia, for diabetes
5. Farxiga, for diabetes, heart failure and chronic kidney disease
6. Entresto, for heart failure
7. Enbrel, for autoimmune conditions
8. Imbruvica, for blood cancers
9. Stelara, for autoimmune conditions
10.    Fiasp and NovoLog insulin products, for diabetes

In 2022, these ten drugs consumed about 20% of Medicare’s total drug spending, which added up to about $50.5 billion. Beneficiaries also shelled out $3.4 billion in out-of-pocket expenses for them.

The Inflation Reduction Act made it possible to negotiate these prices for the first time in Medicare’s history.

“For years, Big Pharma blocked Medicare from negotiating lower drug prices,” President Joe Biden said. “This time, we finally beat Big Pharma.”

Medicare will begin negotiating prices for the next batch of medicines early next year. The process will continue every year with the government negotiating the prices of up to 20 drugs by the end of the decade.