Waiting on Medicare drug prices

Delivered every Tuesday and Friday by 12 p.m., Prescription Pulse examines the latest pharmaceutical news and policy.

Nov 25, 2025 View in browser   By David Lim and Lauren Gardner Programming note: We’ll be off on Thursday but back on our regular schedule next week. Driving the Day The prices of the second round of drugs selected for Medicare negotiations are slated to be revealed by Nov. 30. | Rick Bowmer/AP Photo THE END OF THE MONTH IS NEAR — President Donald Trump has touted a series of drug pricing deals his administration has struck with pharmaceutical companies over the past few months, but we’re still waiting on the results from the second-ever cycle of Medicare drug price negotiations. Those prices must be unveiled by the end of the month. Signed into law by former President Joe Biden, the program’s second year of price negotiations targets 15 drugs used to treat conditions ranging from breast cancer to lung fibrosis. Prices for those drugs that are reached through the talks will kick into effect at the start of 2027. During the program’s first year, government negotiators reached prices for 10 selected drugs that would have saved the government roughly $6 billion if the new 2026 prices had been in effect in 2023. What to expect: Health policy experts anticipate the number could be exceeded during the second cycle, according to Rachel Sachs, a law professor at Washington University in St. Louis who worked as a senior adviser at HHS’s Office of the General Counsel during the Biden administration. “They selected 15 drugs rather than 10,” Sachs said. “More drugs, more potential for savings. And the mix of drugs that they selected included many more specialty drugs than were selected in the first cycle.” That could be important because specialty drugs — such as those used to treat cancer — are often not subject to high rebates, allowing greater ability to negotiate lower prices, according to Sachs. Keep an eye on Novo Nordisk: Trump struck a deal with drugmakers Eli Lilly and Novo Nordisk earlier this month for their weight-loss drugs, which will allow Medicare to pay $245 a month for Ozempic, Wegovy, Mounjaro and Zepbound. Americans on Medicare will be responsible for a $50 co-pay, the White House said when it rolled out the deal. But Novo’s Ozempic and Wegovy have also been part of the second round of price talks — and it is not clear what maximum fair price CMS negotiators reached for the drugs. Looking ahead: The third cycle of up to 15 new drugs selected for Medicare drug price negotiations will be announced by Feb. 1, 2026. Notably, this is the first time drugs in Medicare Part B can be selected — and CMS can also engage in the first cycle of renegotiation for drugs already in the program. Notably, Trump’s One Big Beautiful Bill Act excluded more drugs that treat rare diseases from Medicare negotiations — meaning expensive drugs such as Keytruda and Opdivo are not expected to be eligible for negotiation. “People previously had expected that they would be selected,” Sachs said. IT’S TUESDAY. WELCOME BACK TO PRESCRIPTION PULSE. We hope you have a good Thanksgiving with friends and family. Send tips and turkey to David Lim (dlim@politico.com, @davidalim or davidalim.49 on Signal) and Lauren Gardner (lgardner@politico.com, @Gardner_LM or gardnerlm.01 on Signal).   The shutdown may be over, but the fights on Capitol Hill are just getting started. Inside Congress breaks down how lawmakers are navigating the fallout — and what’s next for funding, leadership, and legislation. ➡️ Sign up for Inside Congress     Eye on the FDA TROUBLES AT WHITE OAK — ICYMI last week, the White House had sought the resignation of a top aide to FDA Commissioner Marty Makary, Lauren scooped, only to reverse course Friday after discovering what a White House official called a series of miscommunications. Sanjula Jain-Nagpal, association director of policy and research strategy in the commissioner’s office, had told agency stakeholders on a call this month that she was now deputy chief of staff — a promotion Makary had requested but that the White House had rejected. That spurred a White House email to HHS leaders Thursday asking for her ouster. The administration official told POLITICO that the White House backed off when told that Jain-Nagpal had not been directly disobeying orders, and she remains at the FDA. She didn’t respond to a request for comment Friday. Research Corner A LIMIT TO GLP-1s — Novo Nordisk’s late-stage clinical trials investigating the GLP-1 weight-loss drug semaglutide’s potential as an Alzheimer’s disease treatment failed to show a statistically meaningful reduction in disease progression, the company said Monday. The results from the “EVOKE” studies mark a major disease area for which the potent drug class hasn’t demonstrated efficacy, as it has for other conditions linked to obesity, such as cardiovascular disease and obstructive sleep apnea. They come ahead of next month’s annual Clinical Trials on Alzheimer’s Disease conference, which will feature the latest research. “Based on the significant unmet need in Alzheimer’s disease as well as a number of indicative data points, we felt we had a responsibility to explore semaglutide’s potential, despite a low likelihood of success,” Martin Holst Lange, Novo’s chief scientific officer and executive vice president of research and development, said in a statement. Analysts at investment banking firm William Blair said in a research note that, if the results had been positive, they had expected “negligible impact” on amyloid-targeting treatments that target the abnormal protein buildup, believing the two drugs would have been used in combination to try to slow disease progression. “Instead, we believe the evoke study misses show the challenge of development in the AD space and highlights that both the [lecanemab] and [donanemab] studies were foundational outcome studies, despite what has been viewed as modest effect sizes,” they wrote. Pharma in the States NY ACTS ON SUD DISPENSING — Democratic New York Gov. Kathy Hochul signed into law last week a measure allowing certain providers in the state to dispense up to three days’ worth of federally approved narcotics medication like methadone and buprenorphine for people with substance use disorder to take off-site, POLITICO’s Katelyn Cordero writes. The new law, which takes effect in late February, applies to hospitals, clinics and emergency departments and brings the state in line with federal regulations. It removes a barrier to care for patients who may have withdrawal symptoms while awaiting placement in addiction treatment programs. Pharma Worldwide MALARIA VAX FUNDING DEAL — Gavi, the Vaccine Alliance, and UNICEF announced a deal Friday that will lower the price point for malaria vaccines to $2.99 a dose in about a year, an effort they said will help protect millions of children from the deadly disease. The agreement is expected to generate up to $90 million in savings. The groups say it will enable the full vaccination of nearly 7 million more children over the next five years. “At this critical juncture of unprecedented decline in funding for international aid, UNICEF is determined to continue our proactive work with partners to deliver enough vaccines at the best possible price to immunize and protect children from preventable diseases,” Leila Pakkala, director of UNICEF Supply Division, said in a statement. Pharma Moves Victor Bulto, president of Novartis’ U.S. operation, will join Labcorp’s board on Dec. 1. Document Drawer The FDA will hold an expert panel on testosterone replacement therapy for men on Dec. 10. What We're Reading Three GOP-led states have broadened their legal challenge to the FDA’s abortion pill regulations to include the agency’s recent approval of a generic form of mifepristone, Reuters’ Nate Raymond writes. Nearly half of Americans say they struggle with health care costs in a POLITICO poll, Sophie Gardner reports.   As part of POLITICO Pro, subscribers get access to Policy Intelligence Briefings — exclusive, interactive sessions with POLITICO’s reporters offering real-time insights on the biggest shifts in policy and politics. ➡️ Learn more about Pro Briefings       Follow us on X David Lim @davidalim Lauren Gardner @Gardner_LM   Follow us

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