Medicare Drug Price Negotiation
Which drugs are next for Medicare price negotiation?
Last reviewed: · Big Sioux Benefits Data Desk
Fifteen more drugs have negotiated prices taking effect January 1, 2027, and on January 27, 2026 CMS announced a further fifteen for January 1, 2028 (CMS, Selected Drugs for Initial Price Applicability Year 2028). The 2028 cycle is the first to include drugs payable under Medicare Part B as well as those covered under Part D, which widens the program beyond pharmacy-dispensed medicines for the first time.
The qualifier: selection is not the same as a price. These fifteen have been selected, and negotiation runs before prices take effect on January 1, 2028. Nothing about the announcement changes what any of them cost in 2026 or 2027. For the second cycle, CMS reports that if the agreed 2027 prices had been in effect during 2024 they would have saved an estimated $12 billion in net covered prescription drug costs, or about $8.5 billion counting Coverage Gap Discount Program spending.
Selected for negotiation, prices effective January 1, 2028
| Drug | Commonly treats | Medicare spending, Nov 2024 to Oct 2025 | Enrollees |
|---|---|---|---|
| Trulicity | Type 2 diabetes | $4.90 billion | 617,000 |
| Biktarvy | HIV-1 infection | $3.90 billion | 101,000 |
| Orencia | Psoriatic and rheumatoid arthritis | $2.45 billion | 72,000 |
| Cosentyx | Plaque psoriasis, psoriatic arthritis | $2.33 billion | 40,000 |
| Erleada | Prostate cancer | $1.95 billion | 19,000 |
| Kisqali | Breast cancer | $1.58 billion | 17,000 |
| Entyvio | Crohn's disease, ulcerative colitis | $1.48 billion | 37,000 |
| Verzenio | Breast cancer | $1.43 billion | 15,000 |
| Botox and Botox Cosmetic | Chronic migraine, overactive bladder, spasticity | $1.14 billion | 390,000 |
| Lenvima | Thyroid, endometrial, liver, kidney cancer | $1.09 billion | 10,000 |
| Xolair | Asthma, chronic spontaneous urticaria | $1.08 billion | 40,000 |
| Rexulti | Major depressive disorder, schizophrenia, agitation in Alzheimer's | $1.08 billion | 119,000 |
| Xeljanz and Xeljanz XR | Psoriatic and rheumatoid arthritis, ulcerative colitis | $1.01 billion | 22,000 |
| Anoro Ellipta | Chronic obstructive pulmonary disease | $0.81 billion | 281,000 |
| Cimzia | Crohn's, plaque psoriasis, psoriatic and rheumatoid arthritis | $0.79 billion | 38,000 |
If you take one of these, the useful takeaway for now is that the $2,100 annual cap already limits your exposure, and the negotiated price will lower the underlying cost in 2028. The current-year list is in which drugs have negotiated prices in 2026.
Sources
- CMS — Medicare Drug Price Negotiation Program: Selected Drugs for Initial Price Applicability Year 2028 — announced January 27, 2026; accessed 2026-08-21
- CMS — Selected Drugs and Negotiated Prices — accessed 2026-08-21
Related questions
Why is Botox on the Medicare negotiation list?
Because Medicare covers it for medical conditions including chronic migraine, overactive bladder, and spasticity, and that use generated $1.14 billion in Medicare spending across 390,000 enrollees over the twelve months CMS measured. Selection reflects Medicare expenditure on covered medical uses, not cosmetic use, which Medicare does not cover.
How many drugs will eventually be negotiated?
The program phases in over time: ten drugs for 2026, fifteen for 2027, fifteen for 2028, with additional drugs selected in later cycles under the statutory schedule. CMS publishes each cycle's selected drug list when it is announced.
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.