Many of the drugs are already facing strong competition from other branded medications or patent expirations that will open the market to generic alternatives.
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.
For example, Merck's Type 2 diabetes drug Januvia could lose exclusivity in mid-2026 – only a few months after the negotiated prices go into effect. Goldstein said she expects to see 90% of the volume from Januvia go to cheaper generic competitors within the first few months of the patent expiration.Eliquis, made by Bristol-Myers Squibb, is used to prevent blood clotting, to reduce the risk of stroke.
"So, doing any negotiating for Januvia today seems like kind of a moot point since it will be losing exclusivity in 2026 and seeing this decline due to generic competition," she told CNBC. Johnson & Johnson's blood thinner Xarelto and Novartis' heart failure drug Entresto are both expected to lose exclusivity in 2027. That means the companies may only feel the impact of negotiated prices for their drugs for about one year before generic competition minimizes the effect of that, Risinger said., is slightly more exposed to the impact of negotiated prices since its patent expires in 2028. But that risk will likely be manageable.
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