The medicines selected for negotiations are taken by millions of Americans to treat conditions like diabetes, cancer and heart disease. The administration identified them in August, beginning a lengthy process intended to result in an agreed-upon price that would take effect in 2026, assuming the negotiation program survives legal challenges.

The initial round of price offers is a key step in the negotiation process. Each drugmaker has until early March to accept the offer or propose a counteroffer to the government. A series of negotiation sessions could follow, with the process set to conclude by August.

Health policy experts said the announcement of the initial round of offers amounted to a kind of starting gun, giving the Biden administration the chance to take an aggressive posture and test the willingness of drugmakers to acquiesce.

The proposals help in “setting the tone for the rest of this back and forth,” said Andrew W. Mulcahy, a health economist at the RAND Corporation who has advised the Biden administration on the implementation of the drug price negotiations.

The administration did not publicly reveal how much it was offering for each drug.

The price negotiation program was created by the Inflation Reduction Act, the climate, tax and health care package that President Biden signed into law in 2022. Additional medications will be chosen for price negotiations in the coming years. The program is expected to save the federal government nearly $100 billion over a decade.

The price negotiation program is a key component of the White House’s efforts to lower everyday costs for Americans, and it is a policy that Mr. Biden can point to as he campaigns for re-election.

“Medicare is no longer taking whatever prices for these drugs that the pharmaceutical companies demand,” Mr. Biden said in a statement on Thursday.

But the pharmaceutical industry is hoping that the courts will step in to shut down the program, which drugmakers say is unconstitutional. The industry has long argued that allowing the government to negotiate prices will curtail private innovation and discourage companies from developing new drugs.

Lawsuits filed by drugmakers, the industry’s main trade group and the U.S. Chamber of Commerce remain ongoing in courts around the country. A federal judge in Delaware heard arguments on Wednesday in a case brought by AstraZeneca, the maker of a diabetes drug that was selected for price negotiations.


Noah Weiland

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