Because this isn’t really a “negotiation” as configured by the statute: Medicare doesn’t have a formulary, it doesn’t pay for drugs, the Part D plan providers (some quite large and with their own negotiating heft) do.
It’s a price-setting exercise. Yes, the drug-maker can walk away, but at the cost of massive punitive excise taxes on selling their drug to anyone in the US, not just Medicare Part D plans.
A little more complicated because in some settings drugs are covered by Medicare part B but generally not if administered yourself at home. Then yes it’s part D and the most out of pocket in Part D from 2025 going forward is $2K.
Also, they do negotiate for a very few drugs and the number is climbing. This was part of the IRA. However only drugs that are FDA approved for your issues are covered.
Before the IRA the government was not allowed to negotiate any drug prices by law which was/is crazy.
What, specifically, wasn’t HHS allowed to do? They weren’t purchasing the drugs.
Certainly the VA can and does negotiate prices for the drugs it buys (that’s one input to the HHS Medicare price-fixing formula), but it has a formulary and is buying drugs for its patients directly.
Exactly.
It's like saying taxes are a "negotiation for a contribution to the state government".