The 2026 list of Medicare negotiated drugs came out this morning and it’s a mad dash to dig in and get some sense of where this program might go. I imagine some companies (hi Astellas) are breathing a sigh of relief and others are glad they didn’t get hit worse.

I found the information released in terms of gross sales and total Part D beneficiaries from June 2022 – May 2023 interesting. A good reminder that while this is process really isn’t all that transparent. The latest data that is publicly available is the 2021 Part D spending dashboard. Using that I compared the chosen drugs against the 2021 spending. The swings in costs and enrollees is interesting. And a very very good reminder that this is all based on gross costs and does not includes discounts and rebates. This is very very very important when considering that most of these drugs are in classes with a lot of competition and heavy rebates required for improved formulary access.

Obviously this is all new and there will be lots more to say but a quick post to get the ball rolling.

And apologies to my US History teacher from high school who would not let us use the word very. Sometimes it just works.