Medicare drug price negotiations may have a muted impact on drugmakers in the near term

Medicare is set to negotiate prices for 10 different drugs with manufacturers in a bid to make those costly treatments more affordable for older Americans – a process the pharmaceutical industry fiercely opposes.

But analysts say the drug price talks will likely have a muted financial impact on manufacturers, at least for this first round of prescription medicines. 

That’s because other factors are already expected to weigh on the revenue and profits of the drugs on the list, which could minimize any negative impact from lower negotiated prices that are set in place. For example, many of the drugs are already facing strong competition from other branded medications or patent expirations in the coming years that will open the market to generic alternatives. 

More broadly, some of the drugs on the list aren’t significant contributors to their company’s business in the first place.

“The commercial impact of negotiations appears limited in the near term for this initial list of drugs,” Mara Goldstein, managing director of Mizuho Securities, told CNBC.

That could change in future rounds of negotiations, analysts say.

The Biden administration unveiled the much-awaited list of drugs Tuesday, officially kicking off a lengthy negotiation process that will end in August 2024. The reduced prices won’t go into effect until January 2026. 

The list names drugs with the highest spending for Medicare Part D, which covers prescription medications, from June 2022 to May 2023. That includes blood thinners from Bristol-Myers Squibb and Johnson & Johnson, and diabetes drugs from Merck and AstraZeneca. 

However, there’s a chance that the negotiated prices will never actually go into effect. Several drugmakers, including a handful whose medications are on the list, have filed lawsuits in different federal courts seeking to stop the negotiations. That could set up split appellate court decisions and fast-track the dispute to the Supreme Court. 

Meanwhile, the U.S. Chamber of Commerce, one of the largest lobbying groups in the country, is seeking a preliminary injunction to halt negotiations before Oct. 1. That’s the same day drugmakers have to sign agreements to participate in the negotiations. It’s unclear whether that effort will be successful. 

Eliquis, a blood thinner from Bristol-Myers Squibb and Pfizer, is slightly more exposed to the impact of negotiated prices since its patent expires in 2028. But that risk will likely be manageable.

“We think Bristol/Pfizer could take a low-mid single-digit hit to their respective 2026 revenue … due to Eliquis negotiation,” Bank of America analyst Geoff Meacham said in a research note Tuesday, adding that the effect of negotiated prices will be limited to 2026 and 2027.

Branded competition is another factor that could mute the impact of negotiated prices, Meacham added.

For example, AbbVie‘s blood cancer drug Imbruvica could see steep declines before its negotiated price goes into effect in 2026, largely due to “competitive erosion” from similar treatments like AstraZeneca’s Calquence and Beigene‘s Brukinsa, according to Meacham.

Competition between similar branded medications has already resulted in rebates and discounts paid to Medicare Part D for some of the drugs on the list. That raises questions about how much lower of a price Medicare can negotiate. 

Cantor Fitzgerald analyst Louise Chen also emphasized that many of the drugs on the list aren’t the key growth drivers of their companies in the first place. That means any decline in a drug’s sales and profits may do little to affect the company’s overall business and stock.

For example, Merck’s Januvia is a smaller revenue and earnings contributor than other drugs in the company’s pipeline, such as its blockbuster cancer drug Keytruda or HPV vaccine Gardasil. Januvia generated $4.5 billion in revenue last year, while Keytruda raked in $21 billion.