Historic Medicare Price Negotiations

Medicare Drug Price Negotiations 2026

For the first time, Medicare can negotiate drug prices. These 10 medications now have lower prices for Medicare beneficiaries, with savings up to 79%.

What Happened?

The Inflation Reduction Act (IRA) gave Medicare the power to directly negotiate prices with pharmaceutical manufacturers. Starting in 2026, the first batch of 10 high-cost drugs will have their prices negotiated by Medicare, resulting in significant savings for beneficiaries.

These are not generic drugs—they're still brand-name medications. The difference is that Medicare beneficiaries now get the negotiated price, instead of paying full market rates.

The 10 Drugs with Negotiated Prices

Effective January 1, 2026 for Medicare Part D beneficiaries

Drug Name Treats Old Price (30-day) Negotiated Price (MFP) Savings
Eliquis Blood clots, stroke prevention $521 $231 56%
Jardiance Type 2 diabetes, heart disease $573 $197 66%
Xarelto Blood clots, stroke prevention $517 $197 62%
Januvia Type 2 diabetes $527 $113 79%
Farxiga Type 2 diabetes, heart failure, CKD $556 $178 68%
Entresto Heart failure $588 $295 50%
Enbrel Rheumatoid arthritis, psoriasis $7,106 $2,355 67%
Imbruvica Blood cancers (CLL, MCL, WM) $14,934 $9,319 38%
Stelara Psoriasis, Crohn's disease, UC $13,836 $4,695 66%
Fiasp/NovoLog Type 1 & Type 2 diabetes (insulin) $495 $119 76%

Note: MFP = Maximum Fair Price (the negotiated price for 30-day supplies). Prices shown are per 30-day supply and are effective January 1, 2026. Actual out-of-pocket costs may vary based on your specific Medicare plan.

The Big Picture

These 10 drugs represent some of the most expensive medications in the U.S. Many beneficiaries spend thousands of dollars per year on a single drug. With these negotiated prices, seniors can:

Are You Eligible?

Who gets these negotiated prices?

Medicare Part D Beneficiaries

If you have Medicare prescription drug coverage (Part D), these prices apply to you when you fill prescriptions at the pharmacy. You'll automatically receive the negotiated price.

Medicare Part B Beneficiaries

If you receive drugs through Part B (administered in an outpatient setting like a hospital or infusion center), the negotiated prices apply to those settings as well.

Non-Medicare Patients

These prices are available only to Medicare beneficiaries. However, manufacturers often offer patient assistance programs and coupons for uninsured or underinsured patients. Check the drug's website.

When Do Prices Take Effect?

The negotiated prices became effective January 1, 2026. If you're a Medicare beneficiary, you should see the lower prices automatically when you fill prescriptions starting in January.

The $2,000 Annual Out-of-Pocket Cap

How the cap works with negotiated prices

Starting in 2024, Medicare Part D beneficiaries have an annual out-of-pocket spending cap of $2,000. This is a major benefit that works alongside these negotiated prices.

How it works:

  1. Phase 1 (Deductible): You pay up to your plan's deductible (typically $120-150)
  2. Phase 2 (Initial Coverage): You and your insurance share costs until you reach $2,000 in out-of-pocket spending
  3. Phase 3 (Catastrophic): Once you hit $2,000, Medicare covers 80% of remaining drug costs for the rest of the year

Impact of negotiated prices: Lower negotiated prices mean you'll spend less out of pocket and reach that $2,000 cap slower. This provides ongoing savings throughout the year.

What About 2027? Next Round of Negotiations

15 more drugs selected for 2027 — This program will continue to grow. The next round of price negotiations is already underway, and Medicare has selected 15 additional drugs to negotiate for 2027.

Expected drugs in future negotiations include medications for diabetes, cancer, arthritis, heart disease, and other chronic conditions. The IRA allows Medicare to negotiate more drugs each year, with up to 60 drugs eligible for negotiation by 2030.

Frequently Asked Questions

Why did Congress allow this?

The Inflation Reduction Act aims to reduce healthcare costs and increase medication affordability for seniors. By allowing Medicare to negotiate, Congress hoped to lower drug prices that have been rising much faster than inflation.

Will there be more negotiations?

Yes. The IRA allows Medicare to negotiate 15 drugs per year starting in 2026, 20 drugs per year starting in 2029, and 20 drugs per year thereafter. By 2030, up to 60 drugs could be negotiated.

Do generic versions exist for these drugs?

No—all 10 of these are brand-name drugs still under patent protection. Generic versions won't be available for years. These negotiations provide savings on the only available version.

How much will I actually save?

Your savings depend on your specific Medicare plan and how much of the drug you use. Many beneficiaries will save hundreds to thousands annually. Your pharmacist can calculate your actual out-of-pocket cost based on your plan.

Do I need to do anything to get these prices?

No. If you have Medicare Part D or Part B coverage, you'll automatically receive the negotiated price. Just fill your prescriptions as normal—the pharmacy will apply the negotiated rate.

What about people with employer insurance?

These negotiated prices apply only to Medicare beneficiaries. Employer plans are not affected by these negotiations. If you have employer coverage, contact your plan administrator about prices for these drugs.

Medical Disclaimer

This article provides information about Medicare drug price negotiations for educational purposes only. It is not medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication. The prices and details shown are current as of March 2026 but may change. For the most up-to-date information, visit Medicare.gov or call 1-800-MEDICARE.