Goodsurance

Drug prices & Part D

CMS Counted a 2020 Reclassification Date for Creon, Delaying Medicare Price Talks by Years, Report Says

Public Citizen says CMS allowed AbbVie to use the date Creon was reclassified as a biologic rather than its original FDA approval date, pushing the drug's eligibility for Medicare price negotiation years into the future.

By the Goodsurance editorial teamAugust 5, 2026

A report released by the consumer advocacy organization Public Citizen around August 5, 2026, says CMS quietly gave AbbVie's pancreatic enzyme drug Creon a longer runway before it can be selected for Medicare drug-price negotiation. Under the Inflation Reduction Act, the clock on when a drug becomes a negotiation candidate starts at its first FDA approval. For small-molecule drugs, the threshold is 9 years; for biologics, it is 13 years. Creon was originally approved as a small molecule, but the FDA reclassified it as a biologic on March 23, 2020, the date Congress designated for converting older drugs under the Biologics Price Competition and Innovation Act. Public Citizen says CMS determined that the 2020 reclassification date, rather than the original approval date, starts Creon's eligibility clock. Using that later date effectively extends the period during which AbbVie can set its own price by roughly seven years compared with using the original approval date. More than 185,000 Medicare beneficiaries used Creon in 2024. CMS has not publicly addressed the methodology behind its eligibility determination for Creon. The outcome for Creon may foreshadow how CMS handles other biologics that were reclassified under the same 2020 deeming process in future negotiation cycles.

A 2020 reclassification date is shielding Creon from Medicare price talks for years longer than critics say it should.

In plain words

A watchdog group called Public Citizen says Medicare's agency let an AbbVie drug called Creon avoid price negotiations for years longer than it should. Creon was first approved as one type of drug, but it was relabeled in 2020 as a different type called a biologic. The agency counted from the newer 2020 date, not the original approval date. Public Citizen says that gives AbbVie about seven extra years before the government can bargain for a lower price. More than 185,000 Medicare patients used Creon in 2024.

Source: Public Citizen
Read at the source →

More news

Other stories on what is moving in Medicare.

Drug prices & Part D

CMS Must Send Final Written Price Offers to 15 Drug Makers by September 30 in Third Negotiation Cycle

The final statutory step before drug manufacturers accept or reject Medicare prices arrives this week. CMS must issue written maximum fair price offers by September 30, and manufacturers have until October 31 to respond. Agreed prices would take effect in 2028.

September 23, 2026

Drug prices & Part D

About 140,000 Wellcare Part D Members Were Dropped Mid-Year After Small New Premiums Were Added to Their Previously Free Plans

KFF Health News found that Wellcare terminated tens of thousands of drug plan members in April 2026 when minimal monthly premiums went unpaid, leaving many without prescription coverage and at risk for permanent Medicare drug enrollment penalties.

September 21, 2026

Drug prices & Part D

MedPAC September Meeting Finds IRA Changes Improved Drug Affordability for Enrollees but May Be Accelerating Overall Medicare Part D Spending

Medicare's congressional advisory commission opened its new study cycle in September finding that Inflation Reduction Act drug benefit changes have helped individual beneficiaries while putting upward pressure on total program spending and future premiums.

September 20, 2026

Drug prices & Part D

Medicare's 2027 Part D Base Beneficiary Premium Will Be 41 Dollars and 33 Cents, Hitting the Inflation Reduction Act's Annual Cap

CMS set the 2027 Part D base beneficiary premium at 41 dollars and 33 cents in July, representing a 6 percent rise from the prior year and the maximum the IRA allows, a benchmark that shapes what drug plans charge as open enrollment approaches.

September 19, 2026

Drug prices & Part D

Federal Watchdog Adds Medicare Part D GLP-1 Overdispensing to Its Active Study List

The Office of Inspector General announced a new evaluation of GLP-1 prescribing patterns in Part D, as the Medicare obesity drug bridge program continues to attract enrollment.

September 17, 2026

Drug prices & Part D

Federal Subsidy That Has Held Down Standalone Medicare Drug Plan Premiums for Two Years Is Ending After 2026

CMS is closing the Part D Premium Stabilization Demonstration after 2026, and a KFF analysis warns that people with standalone prescription drug plans in traditional Medicare could face larger premium increases in 2027 than they have seen in recent years.

September 13, 2026