Medicare has completed its first-ever negotiations with pharmaceutical companies over drug prices. Though only 10 drugs were part of the initial program, the Biden administration announced on Thursday that Medicare will save $6 billion and Americans will save $1.5 billion in out-of-pocket costs in the program’s first year.
Congress for decades prohibited Medicare from negotiating drug prices, something that virtually all other countries do. It’s a chief reason why drug prices are two to four times higher in the United States than in other wealthy countries. The negotiated price list released by the administration on Thursday shows what Americans have been missing out on: Medicare will pay less than half of the current list prices on nine of the first 10 drugs that were included in the program.
“For years, millions of Americans were forced to choose between paying for medications or putting food on the table, while Big Pharma blocked Medicare from being able to negotiate prices on behalf of seniors and people with disabilities,” President Joe Biden said in a statement. “But we fought back — and won.”
The fight is far from over: The negotiated prices will go into effect in 2026; several drugmakers and lobbying groups have sued to try to block the Medicare negotiation program, while Republican lawmakers are eager to repeal it.
The pharmaceutical industry is one of the most powerful and well-funded interest groups in Washington. Its lobbyists have long argued that negotiating drug prices would harm patients, limit access to medicines, and stifle innovation, even though the U.S. government helps fund research and development on all drugs that are approved for sale.
The basic reality is that Americans have been forced to pay the world’s highest prices for lifesaving products they helped finance. This status quo remains, but under Biden, Democrats finally fulfilled their longtime pledge to allow Medicare to negotiate drug prices. Some conservative Democrats helped water down the provision — limiting the number and types of drugs that would be subject to negotiation, and who will benefit — but the program’s successful inclusion as part of the 2022 Inflation Reduction Act was historic — and it opens the door to further expansions down the line.
During this year’s State of the Union speech, for instance, Biden called on Congress to “give Medicare the power to negotiate lower prices for 500 drugs over the next decade.” During her first campaign rally as the presumptive Democratic presidential nominee, Vice President Kamala Harris pledged to “take on Big Pharma to cap prescription drug costs for all Americans.”
Biden and Harris will hold a joint event in Maryland on Thursday touting the administration’s efforts to lower costs for the American people. The Harris campaign said she will announce a policy proposal on Friday pertaining to prescription drug costs.
Per the terms of the IRA, the Medicare drug negotiation program started with 10 expensive, older drugs that have no generic competition despite being on the market for at least nine years. The first round included drugs used to prevent blood clotting, reduce the risk of stroke, and treat diabetes, heart failure, blood cancers, Crohn’s disease, and plaque psoriasis.
As The Lever previously reported, the 10 drugs have all been sold in other countries at far lower prices.
One such drug is Januvia, a pill from Merck that helps adults with type 2 diabetes lower their blood sugar levels. A 2019 report by House Democrats found that Januvia was priced 1,000 percent higher in the U.S. than in international markets on average. Notably, the U.S. National Institutes of Health provided $228 million in funding for research prior to Januvia’s approval.
According to the Biden administration’s negotiated price list, the 2023 list price for a 30-day supply of Januvia was $527. In 2026, Medicare will instead pay $113 — or 79 percent less.
Xavier Becerra, Health and Human Services Secretary, celebrated the price negotiations in an interview with Rolling Stone, noting that the U.S. is going to save billions on “just this first negotiation on 10 drugs,” when there thousands of drugs covered under Medicare.
“If you look at it, if we can bring [one] price down by some 79 percent, why have we been paying these high prices so long, and how much should we actually be paying, and how many more drugs will we find that we can reduce the price of, if we just expand this program?” he said.
Merck launched the first lawsuit to block the Biden administration’s Medicare drug negotiation program, calling it “tantamount to extortion” and arguing that “it violates the Constitution.” Several drug industry lawsuits seeking to block the drug negotiation program have failed. Merck’s case is still pending.
“Every company that is suing us is also negotiating with us,” said Becerra. “Every company that negotiated with us agreed on a price. In some cases, we accepted an offer or counter offer that they came up with, and in the other cases, they accepted the offer [or] counter offer that we came up with. But either way, they agreed.”
He added, “We voluntarily came to an agreement on the price — even though they are suing us. And by the way, every lawsuit that they have filed so far, they haven’t won one.”














War Is Peace: Trump’s Regime-Change Reversal
As American and Israeli rockets fly into Tehran, with the stated goal of regime change, anyone who bought into the self-evidently absurd idea of “Donald the Dove” ending America’s forever wars ought to be suffering from a bloody form of buyer’s remorse.
It was always bullshit. But that’s what the Trump team was selling hard. Take human ghoul Stephen Miller’s tweet days before the election: “Kamala = WWIII. Trump = Peace.”
The Trump team reads George Orwell’s 1984 like an owner’s manual and so of course “war is peace.” Their undermining of NATO and the dismantling of American alliances in favor of a “might makes right” foreign policy executed by a sycophantic kakistocracy is a guarantee of more war amid autocratic power grabs worldwide, with a side order of corrupt crony capitalism to profit from the chaos.
If you voted for Trump and believed him, this is on you. And that includes self-styled Palestinian peace activists who thought that Biden and Harris were the worst of all possible worlds and stayed home. We will no doubt see protests for the innocent lives lost in these strikes — but I’d have a lot more time for those folks if they were also seen protesting the estimated 20,000 to 30,000 Iranian lives snuffed out by murderous mullahs in the last few months alone.
The Islamic Republic of Iran has been despotic and dangerous from its inception. The Iranian people have been oppressed and denied basic freedoms for decades. But this is an extreme example of a war of choice. The American military strikes against Iran’s nuclear weapons facility last year were justified because Iran cannot be trusted with a nuclear weapon. That is true. But the much trumpeted total obliteration of those facilities is apparently not true — or so goes the justification for this war. And don’t forget that it was Trump who pulled the U.S. out of an Obama-era deal to stop Iran from developing weapons — arguing absurdly that the imperfect anti-nuke deal needed to be blown up to stop Iran from developing a bomb. Iran’s subsequent progress toward a bomb then created the rationale toward these strikes. This is a self-inflicted state of emergency. Peace is war and war is peace.
Pity the willful dupes in Congress who deluded themselves into thinking that Trump deserved the Nobel Peace Prize. They’ll probably rationalize that he would’ve been peaceful if he got the honor. Now it will be read as a cautionary tale for not sucking up. The chairman of the Board of Peace is now bored of peace. While Rand Paul remains admirably consistent, it’s Lindsey Graham who is pirouetting around the Senate floor while the Gimp Speaker Mike Johnson is unable to speak for the basic constitutional principles of separation of powers let alone authorization to go to war.
If you’re feeling shell-shocked trying to keep up with Operation Epstein Distraction, get ready for the inevitable next crisis — regime change without a plan for replacement. This is what the Trump administration did in Venezuela — kidnapping the socialist dictator Maduro but keeping his regime in place in exchange for crude oil access. The opposition is still in exile and its leader María Corina Machado gave her Nobel Peace Prize to Trump in exchange for exactly nothing.
One of the clear lessons of history is that if you don’t win the peace, you don’t win the war. The Saudis and their Sunni allies will back the U.S. and Iran because they hate the Shia Iranians (who, incidentally, are not Arabs), but beyond removing the Iranian regime, the plans for replacement and stabilization seem TBD — and with Trump’s inability to stay focused on anything beyond his immediate self-interest, solid plans are unlikely to emerge. Maybe a leader will come from the underground opposition; maybe it will be the Shah’s son, who has been living in the U.S. waiting for a restoration like many members of the diaspora. The upside is that Iran has a distinguished history and an accomplished Persian culture: The Islamists don’t represent the entirety of the people of Iran and never have.
But the path ahead will be messy at best. It will require concerted effort and civil commitment, not just an open call for private investment from Mar-a-Lago members. If the United States is now kidnapping and killing dictators without direct provocation, it establishes a dangerous precedent which will come back to bite us after demolishing our moral authority in the world.
It is the unexpected effects, the cascades of consequence where we cannot always plan ahead, that cause most responsible statesmen to try to keep the peace. But Trump has the carelessness of a rich-boy bully who can always buy or bluster his way out of trouble. He’s a con man who has found his ultimate mark in his followers, who fool themselves into thinking that a reflexive liar is the one man with the courage to tell the truth.
Perhaps the most prominent example is the vice president himself — a bright guy who not that long ago compared Trump to Hitler and a deadly narcotic but then convinced himself that careerism demanded an abrupt conversion. After all, he endorsed Trump less than two years ago with this very serious column headlined “Trump’s Best Foreign Policy? Not Starting Any Wars,” explaining, “He has my support in 2024 because I know he won’t recklessly send Americans to fight overseas.”