TABLE 2.
Top-Spending Drugs Ineligible for Medicare Price Negotiation, 2026-2028
| Brand name | Generic name | Manufacturer | Spending in 2020a, $ | Reason ineligible |
|---|---|---|---|---|
| Part D drugs | ||||
| Revlimid | Lenalidomide | Celgene/BMS | 5,356,050,275 | Generic available |
| Humira | Adalimumab | Abbvie US LLC | 4,166,710,387 | Anticipated biosimilar in 2023 |
| Lantus | Insulin glargine | Sanofi-Aventis | 3,719,082,839 | Biosimilar available |
| Novolog | Insulin aspart | Novo Nordisk | 2,972,656,706 | Interchangeable biosimilar anticipated by 2026 |
| Humalog | Insulin lispro | Eli Lilly & Co. | 2,064,366,203 | Interchangeable biosimilar anticipated by 2026 |
| Levemir Flextouch | Insulin detemir | Novo Nordisk | 1,991,698,847 | Interchangeable biosimilar anticipated by 2026 |
| Victoza | Liraglutide | Novo Nordisk | 1,895,291,574 | Generic anticipated in 2023 |
| Pomalyst | Pomalidomide | Celgene/BMS | 1,453,860,767 | Generic anticipated in 2026, and based on spending, it would not qualify until 2027 |
| Restasis | Cyclosporine | Allergan Inc. | 1,451,534,384 | Generic available |
| Latuda | Lurasidone | Sunovion Pharma | 1,317,919,887 | Generic anticipated in 2023 |
| Entresto | Sacubitril/valsartan | Novartis | 1,203,043,540 | Generic anticipated by 2025 |
| Advair Diskus | Fluticasone/salmeterol | Glaxosmithkline | 1,160,474,903 | Generic available |
| Stelara | Ustekinumab | Janssen Biotech | 1,106,356,248 | Biosimilar anticipated in 2024 |
| Tecfidera | Dimethyl fumarate | Biogen-Idec | 1,054,984,601 | Generic available |
| Shingrix | Varicella-zoster | Glaxosmithkline | 875,670,149 | Ineligible based on years since approval |
| Janumet | Sitagliptin/metformin | Merck Sharp & D | 791,886,114 | Generic anticipated in 2026, and based on spending, it would not qualify until 2027 |
| Aubagio | Teriflunomide | Sanofi-Aventis | 778,201,329 | Generic anticipated in 2023 |
| Vascepa | Icosapent ethyl | Amarin Pharma | 754,811,701 | Generic available |
| Copaxone | Glatiramer acetate | Teva Neuroscien | 713,588,637 | Generic available |
| Vimpat | Lacosamide | UCB Pharma | 709,365,915 | Generic available |
| Basaglar | Insulin glargine | Eli Lilly & Co. | 689,339,162 | Ineligible based on years since approval |
| Dexilant | Dexlansoprazole | Takeda | 651,674,922 | Generic available |
| Part B drugs | ||||
| Eylea | Aflibercept | Regeneron | 3,013,081,886 | Biosimilar anticipated in 2024 |
| Prolia | Denosumab | Amgen | 1,626,844,123 | Biosimilar anticipated in 2025 |
| Rituxan | Rituximab | Roche | 1,295,821,133 | Biosimilar available |
| Lucentis | Ranibizumab | Genentech | 1,113,026,180 | Biosimilar available |
| Orencia | Abatacept | BMS | 1,023,001,524 | Biosimilar anticipated in 2026 |
| Neulasta | Pegfilgrastim | Amgen | 899,790,555 | Biosimilar available |
| Darzalex | Daratumumab | Johnson & Johnson | 837,400,702 | Not eligible until 2029 because of years since approval |
| Avastin | Bevacizumab | Genentech | 680,539,026 | Biosimilar available |
| Remicade | Infliximab | Janssen | 663,412,142 | Biosimilar available |
| Tecentriq | Atezolizumab | Genentech | 624,194,084 | Not eligible until 2030 because of years since approval |
| Ocrevus | Ocrelizumab | Genentech | 618,708,736 | Not eligible until 2031 because of years since approval |
| Soliris | Eculizumab | Alexion | 610,425,468 | Biosimilar anticipated in 2025 |