But from an industrial point of view, the air was not celebratory. They decided in October 2023 to participate in these unprecedented negotiations, as refusal exposed them to “unbearable” consequences, including tax penalties.
Swedish-British groups AstraZeneca and American Johnson & Johnson explained on Thursday that they had withdrawn to ensure that their drugs remain available to Medicare beneficiaries covering the over-65s in the United States.
Diabetes, anticoagulants, psoriasis…
“AstraZeneca believes that anyone who needs our treatments should be able to access them, which was threatened for Medicare and Medicaid patients if a manufacturer refused” to reach an agreement with the authorities. , commented the group. “For this reason, AstraZeneca has accepted MFP for Farxiga,” a diabetes treatment.
The “Maximum Fair Price” system stems from a flagship law of Joe Biden's tenure, the “Inflation Reduction Act” (IRA), a vast energy transition and purchasing power program.
Ten drugs were selected for these negotiations, which began in February and were to end before September 1, which were prescribed in 2022 for about 9 million Medicare beneficiaries.
These include Entresto from Switzerland's Novartis (heart problems), Stelara (psoriasis, Crohn's disease) from Belgium's Janssen, a subsidiary of Johnson & Johnson, and Eliquis (anticoagulant) from Americans Bristol-Myers Squibb (BMS) and Pfizer .
Up to 80% off.
The latter two pointed out in an identical press release that Eliquis was the most prescribed on the list (nearly 4 million beneficiaries) but not the most expensive, and that the Medicare price drop “does not drive the price they want patients pay. “
An argument also supported by Novartis, which states that before the MFP, 98 percent of Medicare beneficiaries taking Entresto paid an average of $29 per month out of pocket. “Price controls do not mean that patients will have better access or pay less at the pharmacy,” the group pointed out.
According to information released Thursday, Medicare will pay $295 for a month of Entresto instead of the current $628, a 56 percent reduction.
The largest decrease (-79%) refers to Januvia (diabetes) from the American group Merck, and the smallest Imbruvica (blood cancer, -38%).
$1.5 billion in savings
The deal will save $1.5 billion for policyholders and $6 billion for taxpayers in the first year, according to the White House.
On the lab shortfall, CFRA analyst Sel Hardy recalled on Thursday that BMS managers “seemed optimistic” at the end of July about the group's ability to weather the shock. She described the final price as “reassuring”.
Drug prices, which are not regulated nationally in the United States, are often much higher than in other developed countries. It is common for policyholders to have to pay a portion, sometimes significant, out of pocket.
“For years, millions of Americans have had to choose between buying medicine and buying food,” Biden said.
Threat to innovation?
But for Johnson & Johnson — two of which are on the list — this price cap will have the effect of raising the cost for other Americans and restricting access to the drug. According to a spokesman, the group believes the IRA is an “arbitrary law lacking a scientific approach to assessing clinical evidence”.
This reform “discourages innovation and limits our ability to discover and develop breakthrough new medicines for those who need them,” Novartis lamented, calling the IRA an “unconstitutional” law.
Several groups have taken legal action since 2023, such as the Danish laboratory Novo Nordisk or Merck, which denounced “extortion”.