What Your Prescriptions Cost
How much does Januvia cost with Medicare in 2026?
Last reviewed: · Big Sioux Benefits Data Desk
Januvia has a Medicare-negotiated price of $113 for a 30-day supply as of January 1, 2026, down from a list price of $527, a 79% reduction (CMS, Negotiated Prices for Initial Price Applicability Year 2026). That is the deepest discount among all ten drugs in the first negotiation cycle. About 843,000 Medicare beneficiaries used it in 2023, accounting for $4.1 billion in Part D gross covered drug costs.
The qualifier: a 79% cut to the drug's price does not translate into a 79% cut to your copay, because your copay was never the full price to begin with. If your plan charges a flat copay for the tier Januvia sits on, your out-of-pocket cost may be unchanged even though Medicare is now paying far less. The change is real, but the beneficiary's share of it depends entirely on how the plan structures cost sharing.
What a year on Januvia looks like
| Step | Illustration under the standard 2026 benefit |
|---|---|
| Drug cost for the year at the negotiated price | About $1,356 |
| You pay during the deductible | Up to $615 |
| You pay after the deductible | 25% of the remaining cost, about $185 |
| Approximate out-of-pocket for the year | About $800, well under the $2,100 cap |
How this illustration is built: the 2026 standard Part D benefit, meaning a full $615 deductible, then 25% coinsurance, then $0 once your out-of-pocket total reaches $2,100. Your plan may use copays instead of coinsurance, may charge a smaller deductible or none, and may place the drug on a different tier, so treat this as the shape of the year rather than a quote. We are not showing plan-specific copays because we will not publish a number we cannot source.
Notice what the deductible does here. At the negotiated price, more than three quarters of your annual cost for this drug is the deductible itself, not the cost sharing that follows it. For a drug in this price range, a plan that waives the deductible on the relevant tier can matter more than one with a lower coinsurance percentage. That comparison is the point of the 2026 Part D deductible.
Sources
- CMS — Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2026 — prices effective January 1, 2026; accessed 2026-08-21
- CMS — Medicare Part D Spending by Drug — CY2025 full year and CY2026 Q1 files; accessed 2026-08-21
- CMS — Announcement of Calendar Year 2026 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Part D benefit parameters) — CY2026 parameters; accessed 2026-08-21
Related questions
Why did Januvia get the biggest discount of the ten drugs?
CMS negotiated each drug separately, considering statutory factors including therapeutic alternatives, research and development costs, and production and distribution costs. Drugs with more clinical alternatives available generally landed at deeper discounts. CMS has not published a per-drug rationale beyond the statutory framework.
Will my Januvia copay drop by 79%?
Probably not, and possibly not at all. The 79% figure describes the drug's price, which is what Medicare and your plan pay against. If your plan charges a flat copay for that tier, your cost may not move. If it charges coinsurance, a percentage of a much smaller number, you should see a real reduction.
Drug costs turn on your specific prescriptions, so the arithmetic is worth doing once, properly: book a free, no-pressure conversation, see your county's South Dakota plan lineup, or browse all answers. SHIINE, the state's free counseling program, is at 1-800-536-8197 and sells nothing.
Big Sioux Benefits is a licensed insurance agency, not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Contact Medicare.gov, 1-800-MEDICARE, or SHIINE (South Dakota's SHIP) for all of your options.