Price Negotiations lower costs on lifesaving prescription drugs for Montanans

Press release

U.S. Sen. Jon Tester announced last Thursday that the cost of 10 lifesaving prescription drugs will officially be lowered as a result of the first price negotiations authorized by the Inflation Reduction Act.

An estimated nearly 25,000 Montana seniors on Medicare will see cost savings up to 79% thanks to Tester’s law, and Medicare enrollees across the country are expected to save $1.5 billion on out-of-pocket costs when the new prices go into effect.

The reduced prices for Montanans were announced today as a result of Tester’s law and will go into effect on January 1st, 2026. Tester was the only member of Montana’s congressional delegation to vote for the Inflation Reduction Act.

“Montanans shouldn’t have to struggle to fill their lifesaving prescription medications because Big Pharma is jacking up prices, and today’s announcement is a big win for Montanans across our state,” said Tester. “That’s why I took the large pharmaceutical companies head-on to pass a commonsense law that will now officially lower the cost of 10 of the most common prescription drugs that Montanans rely on that treat heart disease, cancer, diabetes, blood clots, and more. I’ll continue working to lower costs and put more money back in the pockets of hardworking families.”

Tester was the only member of Montana’s congressional delegation to vote for the act.

He is running for reelection this year and faces Republican Tim Sheehy in the November General Election.

Tester backed provisions in the Inflation Reduction Act that permit Medicare to negotiate the price of covered prescription drugs for the first time ever. The United States Department of Health and Human Services is required to negotiate prices with drug manufacturers for 10 qualifying drugs for 2026, 15 drugs for each of 2027 and 2028, and 20 drugs for 2029 and each following year.

Through Tester’s law, Medicare was granted the power to negotiate high cost drug prices on behalf of patients for the ten following drugs. See below a breakdown of the cost savings secured by Tester which will save Montana seniors hundreds of dollars:

1. Eliquis — an anticoagulant medication used to treat and prevent blood clots and to prevent stroke.

• List Price for 30-day Supply, CY 2023: $521

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $231

• Percentage saved from new price: 56%

• Estimated number of Montana Medicare enrollees who utilize the medication: 10,246

2. Jardiance — an antidiabetic medication used to improve glucose control in people with type 2 diabetes.

• List Price for 30-day Supply, CY 2023: $573

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $197

• Percentage saved from new price: 66%

• Estimated number of Montana Medicare enrollees who utilize the medication: 3,175

3. Xarelto — used to treat and prevent blood clots. May lower the risk of stroke, deep vein thrombosis (DVT), pulmonary embolism (PE), and similar conditions.

• List Price for 30-day Supply, CY 2023: $517

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $197

• Percentage saved from new price: 62%

• Estimated number of Montana Medicare enrollees who utilize the medication: 4,486

4. Januvia — used as a once-daily prescription pill that helps lower blood sugar levels in adults with type 2 diabetes.

• List Price for 30-day Supply, CY 2023: $527

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $113

• Percentage saved from new price: 79%

• Estimated number of Montana Medicare enrollees who utilize the medication: 1,928

5. Farxiga — used to treat type 2 diabetes. Also used to treat adults with heart failure and chronic kidney disease.

• List Price for 30-day Supply, CY 2023: $556

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $178.50

• Percentage saved from new price: 68%

• Estimated number of Montana Medicare enrollees who utilize the medication: 991

6. Entresto — is a fixed-dose combination medication for use in heart failure.

• List Price for 30-day Supply, CY 2023: $628

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $295

• Percentage saved from new price: 53%

• Estimated number of Montana Medicare enrollees who utilize the medication: 858

7. Enbrel — a biologic medical product that is used to treat autoimmune diseases.

• List Price for 30-day Supply, CY 2023: $7,106

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $2,355

• Percentage saved from new price: 67%

• Estimated number of Montana Medicare enrollees who utilize the medication: 197

8. Imbruvica — used to treat certain cancers (such as chronic lymphocytic leukemia/small lymphocytic lymphoma, Waldenstrom’s macroglobulinemia).

• List Price for 30-day Supply, CY 2023: $14,934

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $9,319

• Percentage saved from new price: 38%

• Estimated number of Montana Medicare enrollees who utilize the medication: 83

9. Stelara — used to treat adults 18 years and older with moderately to severely active Crohn’s disease.

• List Price for 30-day Supply, CY 2023: $13,836

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $4,695

• Percentage saved from new price: 66%

• Estimated number of Montana Medicare enrollees who utilize the medication: 62

10. Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill — insulin.

• List Price for 30-day Supply, CY 2023: $495

• NEW Negotiated maximum price for 30- day Supply for CY 2026: $119

• Percentage saved from new price: 76%

• Estimated number of Montana Medicare enrollees who utilize the medication: 2,759

For more detailed information about the negotiated prices people cam see the Centers for Medicare & Medicaid Services (CMS) Negotiated Prices Fact Sheet - PDF. At https://www.cms.gov/files/document/fact-sheet-negotiated-prices-initial-price-applicability-year-2026.pdf .

Montanans thanked Tester for his leadership working to lower the cost of prescription drugs:

“When the pharmaceutical industry raised prices on effective and life-saving drugs for diabetes and life threatening allergic reactions by shocking amounts, Senator Jon Tester said “Enough!” said Barbara Archer of Billings, Big Sky 55+ Board Member. “Jon Tester co-sponsored a bill to finally require Medicare to negotiate drug prices and bring costs down. As I’ve experienced friends and family struggling with bills for cancers and other conditions, I’m grateful that Jon Tester continues to stand up to pharmaceutical companies whose greed is unbounded. Over 100,000 of us on Medicare Part D will save over $98 billion in the next decade. Thank you Jon Tester for helping to lower health care costs.”

“Senator Tester continues to stand up for Montana seniors, and his work on the Inflation Reduction Act will help give me the certainty needed to balance my budget,” said Steven L. Harvey, retired Big Timber resident. “These drugs aren’t optional, and are very expensive — and because of Senator Tester’s work, I’ll finally have some much needed peace of mind when getting my prescriptions filled.”

“If patients cannot afford their medications for chronic diseases such as diabetes it results in the astronautical cost of hospital services and treatment for complications,” said Travis Schule PharmD., CPP, BCPP, Pharmacy Director of Sykes Pharmacy. “Negotiating drug pricing, penalizing drug manufacturers that raise costs above inflation rates, mandating fixed-cost Medicare copays and lowering yearly out-of-pocket costs will allow for patients to have greater access to medications.  The expansion of access will decrease the true cost of healthcare, hospitalization, and treatment of complications resulting from the non-treatment of chronic disease. I applaud Senator Jon Tester for supporting the Inflation Reduction Act, as it shows great leadership to understand where efforts to reduce costs can have extremely large benefits for Montana.”

“Thank you Senator Jon Tester for taking care of business with the Inflation Reduction Act,” said Lee & Patti Scott, retired Helena residents. “For too long, Big Pharma continues to dominate this country with obscene drug costs. Not only will this Act help Seniors, such as ourselves, but it will also help many young families, struggling to just make ends meet.” 

Tester has led the charge to cut costs for Montana’s families and seniors. The Inflation Reduction Act requires Medicare to negotiate drug prices, caps out-of-pocket prescription drug costs for Medicare patients at $2,000/year, caps the cost of insulin for Medicare patients at $35/ month, and extends Affordable Care Act provisions to prevent price hikes for thousands of Montanans. The legislation was signed into law in August 2022 and is fully paid for by holding corporations and billionaires accountable.