Medicare’s “Negotiated Price” for Key Heart Medications Published
As part of the ongoing implementation of the Inflation Reduction Act (IRA), CMS recently announced the negotiated prices for two key heart medications under Part D, Xalerto and Eliquis, beginning January 1, 2026.
A fact sheet explains that the discount of negotiated prices for these drugs from the 2023 list price (based on Wholesale Acquisition Costs (WACs)) is approximately 62% and 52%, respectively.
As part of the FAQs included in the fact sheet, CMS states that “a participating drug company with a selected drug is required to ensure the negotiated price is made available to eligible individuals and to the pharmacies, mail-order services, and other entities that dispense the selected drug to such individuals” and that “CMS will use its comprehensive formulary review process for Medicare prescription drug plans to assess any practices that may undermine access to negotiated prices for selected drugs for people with Medicare.” In March 2025, CMS intends to “make public an explanation of the agreed-upon negotiated prices.”