Missed Last Weeks’ Healthcare.com Roundup? Here’s what happened:
This week’s series covers:
- Second Round of Medicare Price Negotiations from the Biden Administration
- Trump Repeals Extended ACA Enrollment Periods and Drug Pricing Pilots
- The FCC 1:1 Consent Rule Takes Effect Next Week
Biden Administration Reveals Second Round of Medicare Price Negotiations
Before Biden’s exit, the administration announced the next 15 drugs eligible for Medicare price negotiation, including widely used treatments for diabetes, obesity, cancer, and chronic conditions such as asthma and COPD.
These negotiations are part of the Inflation Reduction Act of 2022, which granted Medicare the authority to negotiate drug prices for the first time.
- The Second Round: includes 15 drugs representing about one-third of Medicare Part D spending.
- Negotiation Timeline: Discussions with manufacturers will occur throughout 2025, with new prices effective January 2026.
These include:
- Ozempic (Type 2 diabetes)
- Tradjenta (Type 2 diabetes)
- Janumet (Type 2 diabetes)
- Rybelsus (Type 2 diabetes, cardiovascular disease)
- Wegovy (Obesity, cardiovascular disease)
- Trelegy Ellipta (Asthma, chronic obstructive pulmonary disease – COPD)
- Breo Ellipta (Asthma, COPD)
- Xtandi (Prostate cancer)
- Pomalyst (Kaposi sarcoma, multiple myeloma)
- Ibrance (Breast cancer)
- Ofev (Pulmonary fibrosis)
- Linzess (Chronic constipation, irritable bowel syndrome)
Projected Savings
- Annual Savings: $6 billion projected starting in 2026.
- Policy Impact: Savings will help fund the $2,000 annual Medicare drug copay cap introduced in 2024.
Impact on Patients
- Affordability: Negotiations aim to reduce costs for critical medications, making them accessible to those who struggle to afford them.
Wider Reach: These 15 drugs treat various chronic and life-threatening conditions, broadening the benefits for millions of Medicare beneficiaries.
Read more from H.H.S.
Trump Repeals Extended ACA Enrollment Periods and Drug Pricing Programs in First Week of Office
This week, Trump repealed Biden’s executive order extending enrollment periods for ACA plans in most states and increasing funding for third-party organizations assisting with ACA enrollment.
Trump also revoked a Biden-era executive order that initiated three drug pricing pilot programs under the Center for Medicare and Medicaid Innovation (CMMI).
- The first program aimed to help state Medicaid programs afford high-cost, highly effective cell and gene therapies.
- The second program proposed reduced Medicare payments for drugs approved through the FDA’s accelerated approval process.
- The third program aimed to encourage Medicare prescription drug plans to offer generic medications for chronic conditions at a standardized $2 copay.
Abe Sutton, a former White House and Department of Health and Human Services aide, is expected to lead the Center for Medicare and Medicaid Innovation under the Trump administration.
FCC 1:1 Consent Rule Takes Effect on January 27
Starting January 27, 2025, the 1:1 Consent rule, adopted by the Federal Communications Commission (FCC) takes effect.
This new ruling prohibits marketing communications from using a single consumer consent to send telemarketing robocalls or texts on behalf of multiple sellers. Each seller must obtain separate, prior express written consent from consumers, with clear disclosures and consent specific to their marketing messages.
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