Patients covered under Medicare Part D will pay up to 79% less for 10 prescription drugs for chronic conditions, including ibrutinib for chronic lymphocytic leukemia/small lymphocytic lymphoma and other blood cancers, starting on January 1, 2026, the Centers for Medicare and Medicaid Services (CMS) said. In August 2024, the agency released its final list of lowered drug prices for the 10 treatments selected under the price negotiation program.
CMS negotiated price reductions for nine other drugs in addition to ibrutinib, all of which are indicated to treat chronic conditions that many patients with cancer experience comorbidly, such as diabetes, heart disease, kidney disease, and autoimmune conditions. The agency said that the selected drugs accounted for $56.2 billion (20%) of the total Part D gross covered prescription drug costs during 2023, including $3.9 billion in out-of-pocket costs for patients.
After the new prices take effect in 2026, patients with cancer will pay $9,319 per month for their ibrutinib prescription, down from the current price of $14,934 per month, a 38% decrease. Approximately 17,000 patients covered under Medicare Part D used ibrutinib in 2023, contributing a total net cost of $2,371,858,000 for the program. CMS said that the price reductions for all 10 drugs combines will save patients approximately $1.5 billion in out-of-pocket costs.
“For the first time ever, Medicare negotiated directly with drug companies and the American people are better off for it,” U.S. Department of Health and Human Services Secretary Xavier Becerra said. “Congressional Budget Office estimators predicted about $100 billion savings over 10 years from drug negotiations, and a $3.7 billion savings in the first year alone. Empowering Medicare to negotiate prices not only strengthens the program for generations to come but also puts a check on skyrocketing drug prices.”
The Office of the Assistant Secretary for Planning and Evaluation (ASPE) also released new data in August 2024 detailing historic pricing trends of the 10 drugs selected for the first cycle of the negotiation program. ASPE reported that from 2018 to 2023, list prices increased as much as 55%.
As required by the Inflation Reduction Act, CMS will next select up to 15 more drugs covered under Part D for negotiation for 2027 by February 1, 2025. CMS will select up to 15 more drugs covered by Part B or Part D for 2028 and up to 20 more Part B or Part D drugs for each year after.
Ensuring patients have access to high-quality cancer care that they can afford is an ONS health policy priority. Learn more about ONS’s stance and how you can get involved in advocating for and promoting access to care in the ONS Center for Advocacy and Health Policy.