President Joe Biden and Vice President Kamala Harris on Thursday touted a new Medicare initiative to lower prescription drug prices and save taxpayers billions of dollars, framing the moment as a milestone in Democrats’ decades-long battle with the pharmaceutical industry.

“Two years ago, we gave Medicare the power to negotiate lower prescription drug prices for the first time in history … and now Medicare can use that power to go toe to toe with big pharma,” said Harris, joining Biden for a joint address to supporters in Maryland. The vice president cast the deciding vote on the legislation in 2022 - a key part of her emerging presidential campaign pitch, as Harris seeks to convince voters that she can lower their health-care costs, a perennial concern.

Thursday’s announcement followed a year-long effort by the Biden administration to negotiate with pharmaceutical companies over some of the priciest drugs used by older Americans, resulting in about $6 billion in initial savings, Biden administration officials told reporters, with implications for many patients’ out-of-pocket spending. The new, negotiated prices ranged from 38 to 79 percent lower compared with the drugs’ list prices in 2023.

“We estimate that Medicare enrollees will save $1.5 billion when the new prices go into effect in 2026,” said Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services. “For so many people, being able to afford these drugs will mean the difference between debilitating illness and living full lives.”

The announcement comes as Democrats have struggled to make voters aware of the impending - but not yet realized - benefits of the price negotiations. The lack of public awareness is a challenge for vulnerable Democrats planning to run on the party’s most significant health-care legislation in more than a decade during this year’s fierce battle for control of Congress.

The news was greeted with a shrug on Wall Street, as financial analysts noted that few Americans pay the list prices for drugs and predicted the initiative would do little to affect the drug industry’s bottom line. Republicans criticized the Biden administration’s approach, saying that using Medicare to “fix prices” would reduce drug companies’ incentives to invest in new therapies and would hamper competition.

“There are real issues with drug prices and how we pay for drugs, but this is a terrible solution to an aspect of drug pricing where competition actually drives down net prices,” Alex Azar, a former pharmaceutical executive who served as Health and Human Services secretary during the Trump administration, wrote on social media.

Drug companies also protested the program. “The price-setting process is not objective or transparent and does not reflect the true value of a medicine,” Novartis said in a statement.

The negotiations focused on lowering the price of 10 drugs that treat diabetes, heart failure and other conditions prevalent among older Americans covered by the federal health program. Medicare beneficiaries in 2022 collectively spent $3.4 billion to cover out-of-pocket costs on those drugs, according to a federal analysis released last year. The drugs also represented about one-fifth of the Medicare prescription drug program’s total spending.

For nine of the drugs, the negotiations help cut the price by more than 50 percent, officials said.

In his remarks, Biden vowed to expand the effort to cover more drugs - an initiative that Harris advisers have signaled she would continue if elected.

“We’re going to keep fighting and lower the prescription drug costs for everyone, not just seniors. It’s a fight that we have to continue,” the president said.

It was Biden and Harris’s first joint event since Biden ended his reelection bid and Harris replaced him atop the presidential ticket. Their remarks were frequently interrupted by raucous chants of “Thank you, Joe.”

Democrats and their allies are heralding the initiative as a crowning achievement after years of battling with the pharmaceutical industry. Their 2022 Inflation Reduction Act, which empowered Medicare to negotiate with drug companies and contains other provisions intended to lower the cost of prescription drugs for Medicare beneficiaries, passed without a single Republican vote.

Health officials focused their negotiations with drug companies “on the prices for these drugs, the effectiveness of the drug and the value to the Medicare program,” said HHS Secretary Xavier Becerra, whose agency oversaw the law’s implementation.

The law caps seniors’ out-of-pocket spending on prescription drugs at $2,000 per year - an initiative that takes effect in 2025 and is projected to help save seniors more than $7 billion per year. The law also guaranteed rebates if drugmakers raise the prices of certain drugs faster than the rate of inflation, and capped Medicare beneficiaries’ out-of-pocket spending on insulin at $35 a month.

Biden’s drug-pricing wins are “the number one testing proof point that I’ve seen in focus groups that I personally observed,” a communications strategist at a major Democratic-aligned group, speaking on the condition of anonymity to be candid, said in an interview last month. “Lots of people said they would rein in Big Pharma; he actually got it done.”

The negotiation program is set to be scaled up, with Medicare planning to target 15 additional drugs for negotiations in 2025 and 2026, and 20 drugs per year subsequently.

The initiative is poised to help seniors, said Richard Fiesta, executive director of the Alliance for Retired Americans, an advocacy group for older Americans.

“We do have members already benefiting from the $35 insulin, and now a number of them will also benefit by a lot of these reductions in drug price too,” Fiesta said in an interview. He pointed to frustrations with the high price of Eliquis, a blood-cancer drug included in the negotiations. Eliquis is set to have its price cut by about 56 percent compared with its 2023 list price.

But many Americans have little awareness of Democrats’ efforts. Thirty-six percent of voters said they knew that a law required the federal government to negotiate the price of some prescription drugs for Medicare, according to a poll released in May by KFF, a nonpartisan health-care think tank. About one-quarter of voters said they knew that a federal law would limit out-of-pocket spending on prescriptions for Medicare beneficiaries.

Drug companies have protested that health officials’ negotiations to reach a “maximum fair price” - known as an MFP - are far from fair.

“The imposed ELIQUIS MFP does not reflect the substantial clinical and economic value of this essential medicine, which is widely recognized for its effectiveness in reducing stroke-related events, hospitalizations, and extended rehabilitation needs,” Bristol Myers Squibb said in a statement.

For about three decades, some Democrats had sought regulation of drug prices in Medicare, and lawmakers such as Sen. Bernie Sanders (I-Vt.) had campaigned on the issue. But they faced immense resistance from a deep-pocketed industry that has continued to argue that such a program thwarts drug innovation and chills research into the development of medications.

“Many of our CEOs have talked publicly about promising research projects that they’re canceling as a result of the law,” Stephen J. Ubl, chief executive of the Pharmaceutical Research and Manufacturers of America, the industry’s leading lobbying group, said in an interview with The Washington Post last week.

After intense negotiating and intraparty wrangling, Democrats in August 2022 passed a scaled-back version of their drug negotiation plan, prompting a drug industry legal blitz. Pharma companies are seeking to block the federal government’s ability to negotiate the price of certain prescription drugs, arguing that the law is unconstitutional on several grounds.

The cases are still working their way through the judicial system. So far, no rulings have favored drug companies or their allies. Some of the losses reflect legal technicalities, while other rulings rejected the pharmaceutical industry’s legal arguments, according to Zachary L. Baron, a director of Georgetown Law’s Health Policy and the Law Initiative at the O’Neill Institute.

Ubl described being “in the very early innings of the litigation process. But we believe the courts will ultimately agree that there are constitutional and due process issues” related to the Inflation Reduction Act.

On the other side, Democrats have expressed confidence they will prevail.

“We’ve got the law on our side. We’ve got the facts on our side, and we have the people on our side,” Sen. Amy Klobuchar (D-Minn.), who for years wrote bills to allow Medicare to negotiate drug prices, said on a call with reporters Wednesday. “We’re going to get this done.”

Officials and allies also credited the Biden administration for its efforts to stand up the program. Rachel Sachs, a professor at the Washington University in St. Louis School of Law, framed Thursday’s announcement as “a big milestone.”

“It is difficult to create a federal program, and Congress set an aggressive series of statutory deadlines for CMS and HHS,” said Sachs, who served as a senior adviser at the HHS office of the general counsel, working to implement the drug-price programs, before leaving this year. She also noted that the Biden administration is proposing to use the recent negotiations as benchmarks for negotiating other products and their therapeutic equivalents going forward.

Last August, the Biden administration announced the 10 expensive drugs it selected for negotiation with pharmaceutical companies and the government. More than half of the drugs chosen for the initial round are medications to prevent blood clots or treat diabetes.

In 2023, about 8.8 million people who receive Medicare’s voluntary prescription drug coverage were dispensed these drugs. Here are the negotiated prices:

- For the diabetes drug Januvia: Negotiated 30-day price is $113, down from a 2023 benchmark list price of $527

- Several of Novo Nordisk’s insulin injectors: Negotiated 30-day price is $119, down from a 2023 benchmark list price of $495

- For Farxiga, a diabetes, heart failure and chronic kidney disease drug: Negotiated 30-day price is $178.50, down from a 2023 benchmark list price of $556

- For Enbrel, an arthritis and psoriasis drug: Negotiated 30-day price is $2,355, down from a 2023 benchmark list price of $7,106

- For Jardiance, a diabetes, heart failure and chronic kidney disease drug: Negotiated 30-day price is $197, down from a 2023 benchmark list price of $573

- For Stelara, a psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis drug: Negotiated 30-day price is $4,695, down from a 2023 benchmark list price of $13,836

- For Xarelto, a drug to prevent and treat blood clots: Negotiated 30-day price is $197, down from a 2023 benchmark list price of $517

- For Eliquis, a drug to prevent and treat blood clots: Negotiated 30-day price is $231, down from a 2023 benchmark list price of $521

- For the heart failure drug Entresto: Negotiated 30-day price is $295, down from a 2023 benchmark list price of $628

- For Imbruvica, a drug for blood cancers: Negotiated 30-day price is $9,319, down from a 2023 benchmark list price of $14,934