While the price of 15 prescription drugs is set to drop, only 5.3M Americans will benefit. What you need to know about the new Maximum Fair Prices

Two of the most publicized drugs on this list include Novo Nordisk’s blockbuster obesity drugs Wegovy and Ozempic. However, there’s a wide range of medications on this list for conditions such as cancer, asthma and chronic obstructive pulmonary disease (2).

The CMS estimates that in 2024, 5.3 million Medicare Part D recipients used these soon-to-be-discounted prescriptions. The organization also noted that the discounted drugs represented $42.5 billion (15%) in total gross covered prescription drug costs under Medicare Part D in 2024.

In response to this news, CMS Deputy Administrator and Medicare Director Chris Klomp said he’s “deeply proud of our team, who execute exceptionally well to bring affordability to the country in everything we do.”

​For the millions of older Americans and disabled patients on Medicare who use any of the 15 discounted drugs, there’s no doubt these price changes will bring financial relief. But that doesn’t necessarily mean every American will equally benefit from these lower prices.

Drug price reforms: Fairer or fragmented?

It’s impossible to say how much each Medicare Plan D patient will save on the 15 discounted drugs because everyone has different prescription needs. However, the average savings per patient is roughly $129 across the 5.3 million people who use these drugs (3).​

While some argue Medicare’s negotiation process can genuinely make the system more equitable, others wonder if it’s shifting these price disparities and placing a strain on pharmacies (4).

For example, could the lost revenue from these negotiated drug prices lead to unintended price spikes for other medications? Alternatively, for Americans who are not on Medicare, there’s no guarantee that these negotiated prices will translate into lower costs unless private insurers also renegotiate or pass along discounts.​

Even among Medicare enrollees, not everyone will benefit equally. If a beneficiary doesn’t take any of the negotiated drugs, they may see no price relief at all. Some may even notice price increases if manufacturers raise other drug prices to improve revenue.​

The Association for Accessible Medicines also pointed out that if manufacturers see brand drugs subject to government-imposed price caps, generic competitors may delay or abandon bringing cheaper versions to market (5).​

It’s also worth noting that some previously negotiated drugs like Enbrel and Eliquis are still double the average cost compared with other industrialized nations (6).

On a positive note, the Inflation Reduction Act requires manufacturers to pay a rebate to CMS if the price of certain Medicare-covered drugs increases faster than inflation, helping reduce the risk of excessive increases (7).

Managing costs as Medicare changes

​The impact of this recently announced round of negotiated drug prices will all depend on whether you’re using any of these medications.​