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The U.S. "has always accepted that we are the country that overpays relative to the rest of the world," said one health policy expert.
The Biden administration's Medicare drug price negotiations yielded lowered costs for 10 commonly used drugs, and the White House said last month that Americans would save an estimated $1.5 billion in out-of-pocket expenses thanks to the talks—but an analysis out Tuesday found that the U.S. will still be paying far more than other wealthy countries.
Reuters reviewed the maximum prices that Australia, Japan, Canada, and Sweden have agreed to pay for nine of the 10 drugs for which Medicare negotiated prices this year, and found that the U.S. will still be paying more than double the amount for the medications on average.
The new prices are set to go into effect on January 1, 2026, but two of the highest prices the U.S. will still pay are for Imbruvica, for blood cancers, and Stelara, for conditions including Crohn's disease and psoriasis.
Medicare will be charged $9,319 for a 30-day supply of the latter drug, compared to $4,607 in Sweden. For Stelara, the U.S. will pay $4,695 under the negotiated prices—more than four times the amount it costs in Sweden, Australia, and Canada.
For Enbrel, which treats conditions including arthritis, Medicare will pay $2,355 per month—far less than the list price of $7,106, but still more than $1,000 over what Sweden is charged: $709. Australia pays $573, while Canada pays $704, and Japan pays just over $300 for the drug.
"The government negotiations are especially significant for drugs where market forces were most limited and therefore had the least impact on producing price concessions."
Stacie Dusetzina, a professor of health policy at Vanderbilt University, told Reuters that the U.S. has "always accepted that we are the country that overpays relative to the rest of the world."
The analysis comes two weeks after the Brookings Institution published a review of the impact of the United States' first federal negotiations of prescription drug prices, finding that just three of the drugs which had little competition in the market accounted for more than half of the $6 billion the U.S. is expected to save in 2026.
"The government negotiations are especially significant for drugs where market forces were most limited and therefore had the least impact on producing price concessions," said Brookings.
Reuters noted that in other countries, prices generally come down over time, but U.S. drugmakers are able to raise prices annually and often extend patents by making small changes to medications, stopping less expensive generic versions from hitting the market and saving patients money.
Unlike in other wealthy countries, Johns Hopkins Bloomberg School of Public Health scientist Mariana Socal told Reuters, "the longer a drug is in the U.S. market, the more we pay."
With previous list prices well into the hundreds and thousands for the 10 drugs included in negotiations so far, Medicare agreed to pay close to $200 for a 30-day supply for drugs including Xarelto, Jardiance, and Farxiga—medications for which other governments examined by Reuters pay $78 or less, thanks to their longstanding negotiations.
The RAND Corporation found in a study in February that before the Medicare negotiations were included in the Inflation Reduction Act, U.S. health plans paid more than three times as much as other countries for brand-name drugs, even after discounts.
"A contributor to higher U.S. per capita drug spending is faster uptake of new and more expensive prescription drugs in the United States relative to other countries," wrote researchers at the London School of Economics in a study in 2013. "In contrast, the other OECD countries employed mechanisms such as health technology assessment and restrictions on patients' eligibility for new prescription drugs, and they required strict evidence of the value of new drugs."
The researchers suggested pharmaceutical companies in the U.S., like in other countries, should be required "to provide more evidence about the value of new drugs in relation to the cost" and negotiate prices accordingly.
As Merith Basey, executive director of Patients for Affordable Drugs, said in August after the results of the first round of negotiations were announced, advocates are still pushing for far more savings in upcoming talks between Medicare and drug manufacturers, which are expected to start next year.
"We remain committed to expanding the Medicare negotiation program to more drugs," said Basey last month, "and fighting for additional reforms to lower drug prices for all patients who need relief."
"Trump's Project 2025 agenda will take us backward and leave more Americans sick, uninsured, and burdened with crushing medical debt."
Congressional Democrats marked Medicare's 59th anniversary on Tuesday by releasing a tool showing the potential district-by-district impact of Republican presidential nominee Donald Trump's proposal to roll back the Inflation Reduction Act, a law that
capped insulin costs for seniors at $35 a month.
The new tool, produced by Democrats on the House Budget Committee, allows users to plug in their address, ZIP code, or district to view how a repeal of the 2022 law would affect the costs of insulin and other medications.
In Pennsylvania, for instance, "830,000 seniors and people with disabilities in Pennsylvania" would have to "pay an average of $470 more every year for prescription drugs" if Trump and the right-wing groups behind Project 2025 get their way.
Project 2025's sprawling policy document—which at least 140 former Trump administration officials helped craft—calls for the "repeal of massive spending bills like the Infrastructure Investment and Jobs Act (IIJA) and Inflation Reduction Act (IRA)."
"These programs are lifelines for millions of Americans, but the Trump-Vance ticket and their extreme allies threaten to cut funding."
Nationwide, Democrats on the House budget panel estimate that a repeal of the IRA would raise drug costs for at least 18 million seniors.
Project 2025 would also "make Medicare Advantage the default enrollment option" for seniors—a step toward the
total privatization of Medicare.
"For 59 years, Medicare and Medicaid have served as a critical lifeline for seniors, families, children, Americans with disabilities, and so many others," Brendan Boyle (D-Pa.), ranking member of the House Budget Committee, said in a statement Tuesday. "Unfortunately, extreme MAGA Republicans have a different, darker vision for our healthcare system."
"Trump's Project 2025 agenda would repeal the lifesaving provisions of the Inflation Reduction Act, raise premiums on seniors, and risk their access to doctors and services under Medicare," Boyle continued. "House Republicans' budget plans show they are 100% on board with Trump's Project 2025 agenda, which will give Big Pharma a windfall while putting the tens of millions of Americans who get their health coverage through Medicare, Medicaid, and the [Affordable Care Act] on the chopping block."
"Make no mistake," he added, "Trump's Project 2025 agenda will take us backward and leave more Americans sick, uninsured, and burdened with crushing medical debt."
Since President Joe Biden signed it into law, Trump has repeatedly assailed the IRA, calling it a "mammoth socialist" law and signaling that he would work to dismantle it should he win another four years in the White House.
While Trump and Republican lawmakers have postured as defenders of Medicare and Social Security—the GOP's 2024 platform vows to "fight for and protect Social Security and Medicare with no cuts"—their actions while in positions of power belie their rhetoric.
Trump proposed major cuts to Social Security, Medicare, and Medicaid programs during each of his first four years in the White House, and a congressional panel comprised of three-quarters of the House Republican caucus released a budget blueprint last year that called for raising the retirement age—which would cut Social Security benefits across the board.
As recently as March, Trump declared in an interview that "there is a lot you can do... in terms of cutting" programs like Social Security and Medicare. The former president later tried to walk back the comments.
Sen. JD Vance (R-Ohio), Trump's running mate, once described Social Security and Medicare benefits as "the biggest roadblocks to any kind of real fiscal sanity."
"These programs are lifelines for millions of Americans, but the Trump-Vance ticket and their extreme allies threaten to cut funding—just like Trump proposed every year of his presidency—and undo the Biden-Harris administration's work to lower prescription drug costs for seniors," Alex Floyd, rapid response director for the Democratic National Committee, said Tuesday. "Trump and Vance's Project 2025 agenda to leave our seniors high and dry is destructive, extreme, and deeply unpopular—which the American people will make clear when they reject it in November."
Ammar Moussa, a spokesperson for Vice President Kamala Harris' presidential campaign, echoed that sentiment, calling Trump "the biggest threat to Medicare, Medicaid, and Social Security since their inception."
"He tried cutting Social Security and Medicare every single year he was in office," Moussa said Tuesday. "There is only one candidate in this race who will protect and expand earned benefits programs that millions of Americans rely on—Vice President Harris."
"The Biden administration has made strides in drug pricing in response to the great many advocates demanding transformative change to end Big Pharma profiteering. But much more needs to be done," Public Citizen's Access to Medicines program director Peter Maybarduk said.
This is a developing story... Please check back for updates...
U.S. Sen. Bernie Sanders and President Joe Biden will appear together to discuss the need to lower the cost of prescription drugs on Wednesday.
"Biden and Sanders plan to discuss their joint efforts to lower the out-of-pocket cost of inhalers for tens of millions of Americans who rely on the devices to treat asthma and other conditions, speaking to an audience of about 75 health policy experts and advocates, according to White House officials who previewed the remarks," The Washington Postreports.
The event will take place at 11:00 am Eastern time.
Watch the event below:
"The Biden administration has made strides in drug pricing in response to the great many advocates demanding transformative change to end Big Pharma profiteering. But much more needs to be done," Public Citizen's Access to Medicines program director Peter Maybarduk said in a statement.
Biden has made lowering drug prices a key element of his 2024 campaign for reelection. He intends to speak about capping insulin costs for Medicare patients at $35 a month and legislation that's being worked on to cap the out-of-pocket healthcare costs for seniors at $2,000 a month.
"The caps do not solve every problem, but they certainly will benefit a large number of patients with asthma and [chronic obstructive pulmonary disease] who rely on inhalers," said William Feldman, a pulmonologist and health policy researcher at Harvard Medical School.
Biden framed his healthcare initiatives as a battle against Big Pharma on Wednesday.
"Finally. We beat Big Pharma. Finally," Biden said, referencing capping insulin costs. "I’m proud of my administration taking on Big Pharma... Bernie is the one who has been leading the way for decades."