Legislation passed in 2022 called for Medicare to negotiate prescription drug prices with pharmaceutical companies. Several of them have sued to stop the process.
Nonetheless, the federal government plans to pick the first batch of drugs to haggle over by September. And a recent analysis of Medicare data from nonprofit health policy group KFF highlights the way this strategy could work.
KFF found that a handful of prescription drugs made up nearly a quarter of the federal health insurance program’s Part D spending — nearly $48 billion of $216 billion — in 2021. Medicare Part D covered 3,566 drugs in 2021.
Following are the prescription drugs that account for the largest share of Medicare spending.
10. Ozempic
Total Medicare spending on this prescription drug in 2021: $2.6 billion
Number of people using this drug in 2021: 458,600
Ozempic, which boosts the body’s natural insulin production, helps diabetics manage blood sugar and lowers the risk of heart attack. It also suppresses appetite, which may lead to weight loss.
It is made by Novo Nordisk. The drug was approved too recently (2017) to be part of the current round of price negotiations, KFF says.
9. Lantus Solostar
Total Medicare spending on this prescription drug in 2021: $2.8 billion
Number of people using this drug in 2021: 1.1 million
Lantus SoloStar is an insulin product made by Sanofi.
Because of an alternative called Semglee, Lantus won’t be part of current price negotiations. The Lantus maker also cut the price of the drug by 78% in early 2023.
8. Humira Pen (Citrate-free)
Total Medicare spending on this prescription drug in 2021: $2.9 billion
Number of people using this drug in 2021: 51,200
Humira is a prescription drug used to treat arthritis, psoriasis and Crohn’s disease, among others. It is made by AbbVie.
Because alternatives to Humira exist, it won’t be part of current price negotiations.
7. Imbruvica
Total Medicare spending on this prescription drug in 2021: $3.2 billion
Number of people using this drug in 2021: 26,000
Imbruvica is a cancer treatment drug made by Pharmacyclics and Janssen, pharmaceutical companies owned by AbbVie and Johnson & Johnson, respectively.
It has the second-highest average spending per beneficiary among the drugs on this list — $121,000 per person. (Most are roughly between $3,000 and $7,000.)
6. Jardiance
Total Medicare spending on this prescription drug in 2021: $3.7 billion
Number of people using this drug in 2021: 884,500
Another of the diabetes drugs in the top 10, Jardiance is made by Eli Lilly and Boehringer Ingelheim.
5. Januvia
Total Medicare spending on this prescription drug in 2021: $4.1 billion
Number of people using this drug in 2021: 934,500
Januvia, which can cost as little as $5 per prescription through private insurance, helps manage blood sugar for type 2 diabetics. It is made by Merck.
4. Trulicity
Total Medicare spending on this prescription drug in 2021: $47 billion
Number of people using this drug in 2021: 663,900
Trulicity is another drug used to treat Type 2 diabetes made by Eli Lilly.
The drug was approved too recently (2014) to be part of the current round of Medicare price negotiations.
3. Xarelto
Total Medicare spending on this prescription drug in 2021: $5.2 billion
Number of people using this drug in 2021: 1.3 million
Xarelto is used to reduce the risk of blood clots and strokes. It is made by Janssen.
2. Revlimid
Total Medicare spending on this prescription drug in 2021: $5.9 billion
Number of people using this drug in 2021: 45,600
Revlimid is a cancer-treating drug made by Bristol Myers Squibb. It is the most expensive drug per beneficiary on this list, at $129,000 per person.
Because there is now a generic version of Revlimid being gradually introduced to the market, it won’t be part of current price negotiations.
1. Eliquis
Total Medicare spending on this prescription drug in 2021: $12.6 billion
Number of people using this drug in 2021: 3.1 million
Eliquis is made by Pfizer. It’s a blood thinner used to reduce the risk of stroke and blood clots.
