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iStock, Zolak The discounts should be compared against the drugs’ “ultimate net price” rather than their indicated list price to gauge the true impact of the negotiations, BMO Capital Markets analysts said. Negotiations for the second cycle of the Inflation Reduction Act’s drug pricing program have wrapped up, and the Centers for Medicare and Medicaid Services on Tuesday released the final agreed-upon prices for the 15 covered medicines. The discounts from list prices negotiated by CMS range from 38% for Teva Pharmaceuticals’ Huntington’s disease chorea therapy Austedo to 85% for Merck’s diabetes drug Janumet. Novo Nordisk’s Ozempic and Wegovy—arguably the most closely-watched drugs on this list—will sustain a 71% cost cut from their list price. The prices are set to take effect on Jan. 1, 2027. Analyst responses to the list were subdued. The final negotiated prices, Guggenheim Partners wrote on Tuesday evening, turned out to be “roughly in line” with expectations. The firm pointed to “the extensive gross-to-net adjustments that the manufacturers are already providing on these drugs.” BMO Capital Markets, for its part, wrote in a note to investors, “We reiterate that the important comparison remains the difference between the product’s newly discounted price and the product’s ultimate net price, including rebates,” instead of their list prices. Guggenheim also pointed out that many of the drugs under negotiation have already peaked in sales or have biosimilar or generic competition expected soon. Therefore, “Any impact on sales from lower prices will only impact the companies for a handful of years.” The final maximum fair prices are listed below: Centers for Medicare & Medicaid Services Tuesday’s pricing reveal comes amid the Trump administration’s push to lower drug costs in the U.S., for which it has launched several initiatives and struck a number of deals. Earlier this month, for instance, the White House came to an agreement with Novo and fellow obesity leader Eli Lilly to offer their respective GLP-1 drugs through the government’s forthcoming direct-to-consumer (DTC) platform at a steep discount. Ozempic and Wegovy, which have list prices of $1,000 and $1,350 per month, respectively, will be available for $350 on TrumpRx, while Lilly’s Zepbound will drop from $1,068 per month to $346 on the DTC marketplace. When the oral versions of their obesity drugs hit the market, the pharmas also promised to make their initial doses available for $150. Aside from Novo and Lilly, other pharma companies have joined the TrumpRx program . Pfizer kicked off this trend in late September when it partnered with the government to offer some of its products—including the eczema drug Eucrisa and the migraine nasal spray Zavzpret—on the DTC site. AstraZeneca followed suit soon after and promised to put many of its inhalers on TrumpRx. The centerpiece of the administration’s pricing push is its Most Favored Nation rule , announced in May. This executive order directs drug costs in the U.S. to be lowered to the same level as they are in similarly developed nations—a pricing philosophy that guides the other government initiatives, including its DTC program.

Chicago: Novo Nordisk 's highly anticipated but ultimately unsuccessful Alzheimer's trials were a long shot for the maker of blockbuster drugs Ozempic and Wegovy, but scientists are still asking if GLP-1 drugs should be tested to prevent the disease in people at risk. Novo's trials tested Rybelsus , an older pill form of semaglutide, the same main ingredient in Ozempic and Wegovy injections. The drug failed to meet the studies' primary goal of delaying cognitive decline in hundreds of people with early-stage Alzheimer's disease. But in a release scant on details, the Danish drugmaker said Rybelsus did improve some unspecified Alzheimer's-related biological processes in both trials - clues that could help guide new studies, Alzheimer's experts said. That leaves open "a tiny window of hope that in future this drug might be effective if used earlier as a preventative strategy," said Professor Tara Spires-Jones, director of the Centre for Discovery Brain Sciences at the University of Edinburgh. Spires-Jones noted that diabetes and obesity are both associated with increased risk of developing Alzheimer's, conditions that are treated effectively with the GLP-1 drugs now taken by millions of people. "Future trials are needed to confirm whether GLP-1 drugs might be effective in preventing Alzheimer's disease," she said. Other GLP-1 drugs include Novo rival Eli Lilly's Zepbound and Mounjaro, which also hit an additional target called GIP. DETAILS EXPECTED NEXT WEEK Novo plans to discuss the findings at an Alzheimer's conference in San Diego on December 3. Dr. Eric Reiman, chief executive of the Banner Alzheimer's Institutes in Arizona, said the results are disappointing but do not rule out GLP-1s for people at risk of the disease but who don't yet have symptoms. "I'm eager to see the trials' biomarker findings and other details of the study next week, including any findings that might help the field consider its potential benefits in cognitively unimpaired people," he said. Dr. Zaldy Tan, a geriatrician at Cedars-Sinai in Los Angeles, said Novo's cancellation of the one-year follow-up trial suggested to him that "it wasn't promising at all." Nevertheless, he said he is waiting to hear about other outcome measures, such as changes in Alzheimer's-related proteins in the blood. DATA SHOW EARLY GLP-1s CUT DEMENTIA RISK Novo's trials focused on people with early Alzheimer's disease as confirmed by the presence of clumps of a protein called beta amyloid in their brain, the target of the two approved treatments for the mind-wasting condition. Much of the evidence from large population studies suggesting a potential benefit from GLP-1s comes from studies of people with diabetes who are at increased risk of vascular dementia, a condition marked by damage in small blood vessels in the brain. An April study in JAMA Neurology of medical records from nearly 400,000 people with diabetes aged 50 and older found that those taking GLP-1s had a 33% reduced risk of developing dementia. "When we look back at very large populations, people who got GLP-1s appeared to not get Alzheimer's disease as frequently as people who did not take it or who took different diabetes medications," said Dr. Steven DeKosky of the University of Florida's Alzheimer's Disease Research Center in Gainesville, who was part of that study team. Even before Novo's preliminary results were released, Dr. Mary Sano, a Mount Sinai Alzheimer's researcher and an investigator in the trials, expressed concern that the focus on testing the drug in patients with confirmed Alzheimer's may have inadvertently excluded many people with diabetes and potentially vascular dementia from the trial. Ivan Koychev, clinical associate professor in neuropsychiatry at Imperial College London, said in an emailed comment that when the disease is more advanced, preventing further decline in the underlying biology may not be sufficient to show a clinically meaningful benefit. "This is a recurring theme in Alzheimer's disease therapeutics," he wrote. "The results reinforce the need to test these agents much earlier, ideally years before symptoms emerge, when neuronal systems are more intact and the potential for clinical benefit is greater." (Reporting by Julie Steenhuysen; Editing by Caroline Humer and Bill Berkrot)