As President Donald Trump touts new agreements with cut the cost of blockbuster drugs like Wegovy and Zepboundhe made little mention of the Medicare drug price negotiation program, although the government is expected to announce price cuts before the end of the month.
Program created under President Joe Biden Inflation Reduction Act of 2022gave Medicare the authority to negotiate directly with drug makers for some of its most expensive drugs.
A spokesperson for the Centers for Medicare and Medicaid Services (CMS) said the agency is preparing to release a second round of negotiated prices by Nov. 30, covering 15 drugs, up from 10 last year, and adding Ozempic and Vegovoy to the list. The new agreed prices will not come into force until 2027.
The lack of attention has puzzled health policy experts, who say the program could play a major role in lowering prescription drug costs for millions of U.S. seniors.
According to the data, about one in five adults say they have not filled a prescription because of cost. poll from the nonpartisan health policy research group KFF.
“Of course, a flurry of announcements and a lack of details [on negotiations] it's confusing,” says Dr. Benjamin Rome, a primary care physician and health policy researcher at Harvard Medical School.
Trump's approach to lowering drug prices relied heavily on executive orders and voluntary agreements with drug makers rather than legislation. Last week, it announced an agreement with Novo Nordisk and Eli Lilly — makers of Wegovy and Zepbound, respectively — to cut prices on some doses in exchange for lower tariffs and faster Food and Drug Administration review of new drugs. Several experts described details as unclear and questioned whether the agreements would result in real savings for Americans. Trump has made similar deals with Pfizer and Astrazenca.
Rome said the Medicare negotiation program is seen as a more sustainable and reliable path to lower costs for Americans.
Drugmakers could opt out, but doing so would likely require removing their drugs from Medicare entirely, cutting them off from one of the country's largest markets. Several companies have challenged the negotiation program in court, but these lawsuits have so far been unsuccessful.
“While it's great that the Trump administration wants to aggressively negotiate lower prices with pharmaceutical companies, these ad hoc talks appear to be more about declaring short-term policy victories,” Rome said.
“I would be very skeptical about relying solely on voluntary agreements with drug manufacturers as the primary policy for making drugs more affordable for Americans,” Rome added. “On the contrary, the IRA will absolutely save taxpayers money through the negotiation process.”
Despite the looming announcement, the White House has said little publicly about the negotiating agenda or how it fits into Trump's broader push to lower drug prices.
In an emailed statement, White House spokesman Kush Desai said: “Democrats have endlessly touted the Inflation Relief Act, which, ironically, has accomplished little under Biden's leadership other than increasing Medicare premiums. The Trump Administration is focused on results, and our historic drug pricing agreements with the world's pharmaceutical giants are proof that we will continue to deliver meaningful change for the American people.”
Last year, the Biden administration announced agreements to reduce prices on 10 prescription drugs under the Medicare program, with these cuts scheduled to take effect in 2026. The drugs included the blockbuster blood thinner Eliquis, as well as several drugs to treat cancer and diabetes. At the time, administration officials projected that the negotiations would save Medicare beneficiaries $1.5 billion in out-of-pocket costs in the first year.
Experts say the second round could have an even bigger impact than last year's, as some of the drugs on the list — especially Ozempic and Wegovy — become the most widely used and most expensive in Medicare.
The Congressional Budget Office, a nonpartisan government group that provides budget and economic information to Congress, projects that the negotiations will net price of Ozempic and Wegovy 'will fall significantly' Beginning in 2027, reduce Medicare spending per patient using medications by one-third. CBO also expects that these lower prices will likely put pressure on other GLP-1 drugs, including Mounjaro and Zepbound.
Stacy Dusetsina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said the negotiations may have influenced Trump's deal for Wegovy and Zepbound last week.
When asked on a call with reporters whether Trump's deal was tied to the negotiations, senior administration officials said it was not.
“We are all looking forward to the announcement of what prices have been agreed upon,” Dusetsina said. “It is quite possible that this is where the negotiations ended.”
Other experts have raised questions about how Trump's deal fits into the negotiations — or whether the two efforts align at all.
Tricia Neuman, executive director of the Medicare Policy Program at KFF, said it is “not clear how the recent White House announcement aligns with the Inflation Relief Act when it comes to negotiated prices for GLP-1.”
Rome said Trump's agreements were unlikely to interfere with or undermine the negotiation process.
“This process is very clearly outlined in CMS, it continues throughout the year and will repeat for 20 more drugs early next year,” he said. “I don’t think these side deals with Lilly and Novo are going to change that.”
Neumann added that while voluntary agreements may get more attention from the White House, they do not replace the long-term consequences of Medicare negotiations.
“The Medicare IRA negotiation program is enshrined in law, it's up and running, and it could ultimately lead to lower prices for many more drugs over time,” she said.
