Medicare Negotiated Drug Prices: The Complete List
Medicare now negotiates the price of its highest-spending drugs. Ten took effect on January 1, 2026. Fifteen more take effect on January 1, 2027. Fifteen more are in negotiation right now for January 1, 2028, and those prices are due to be published by November 30, 2026.
Below is every drug and every price, in one place. Read the next section first, though, because almost every write-up of this program leaves out the part that decides what you actually pay.
The negotiated price is not your copay
This is the single most misunderstood thing about the program, and it changes whether any of the numbers below help you.
The maximum fair price is what Medicare and your Part D plan pay the pharmacy. Your share is set separately, by your own plan's tier structure. So:
- If your plan charges coinsurance, a percentage of the drug price, a lower negotiated price lowers your share directly. A 25% coinsurance on $654 is $164. On $175 it is about $44.
- If your plan charges a flat copay for that tier, say $47, your copay may not move at all when the negotiated price arrives.
- Either way it changes your pace. Less is being spent on your behalf, so you reach your annual Part D out-of-pocket cap more slowly. For some people that is a loss, not a gain, because hitting the cap is what makes the rest of the year free.
- It changes no coverage rule. Prior authorization, step therapy and quantity limits all still apply exactly as before.
And none of it applies if you are not on Medicare. On commercial insurance the list price is unchanged for you, and your cost comes from your own formulary and deductible.
The 2028 drugs: selected, prices pending
CMS named these 15 drugs on January 27, 2026. The negotiation period closed on November 1, 2026, and CMS must publish any agreed prices by November 30, 2026, to take effect January 1, 2028. Spending and patient counts below are the CMS figures for November 2024 through October 2025, the window used to pick them. Together these drugs accounted for $27.0 billion and about 1,777,000 people, roughly 6% of all Part B and Part D spending.
| Drug | Medicare spend |
|---|---|
| Trulicity | $4.90B |
| Biktarvy | $3.90B |
| OrenciaPart B | $2.45B |
| Cosentyx | $2.33B |
| Erleada | $1.95B |
| Kisqali | $1.58B |
| EntyvioPart B | $1.48B |
| Verzenio | $1.43B |
| Botox, Botox CosmeticPart B | $1.14B |
| Lenvima | $1.09B |
| Xolair | $1.08B |
| Rexulti | $1.08B |
| Xeljanz, Xeljanz XR | $1.01B |
| Anoro Ellipta | $813M |
| CimziaPart B | $787M |
Tradjenta was also selected for renegotiation in this cycle. It already has a negotiated price of $78 for 2027, and CMS is reopening it. See Tradjenta cost.
2028 is the first round to include Part B drugs, and that matters for your bill
The first two cycles covered only pharmacy drugs under Part D. This one reaches drugs payable under Part B, the ones given to you in a clinic, infusion suite or doctor's office. Orencia, Entyvio, Cimzia and Botox all carry meaningful Part B volume.
If you get one of these, your cost behaves nothing like a pharmacy copay:
- It arrives as a medical claim, usually with a separate facility or administration charge next to the drug itself. Two or three line items for one appointment is normal.
- Part B generally leaves you 20% coinsurance with no annual out-of-pocket cap, unless you have a Medigap policy, Medicare Advantage, or other supplemental coverage. On a drug costing thousands per dose, 20% is the whole problem.
- Where the drug is given can change the price substantially. The same infusion in a hospital outpatient department often costs more than in a physician's office, because of the facility fee.
Botox is the clearest trap in the list. It is covered for chronic migraine, spasticity and overactive bladder, and not covered cosmetically, so the coding on your claim decides whether you owe a copay or the entire charge.
The 2027 prices, effective January 1, 2027
CMS published these on November 25, 2025. Prices are per 30-day supply. List price is the 2024 wholesale acquisition cost. We have a detailed page for each one.
| Drug | List | Negotiated |
|---|---|---|
| Semaglutide (Ozempic, Rybelsus, Wegovy) | $959 | $274 |
| Trelegy Ellipta | $654 | $175 |
| Xtandi | $13,480 | $7,004 |
| Pomalyst | $21,744 | $8,650 |
| Ibrance | $15,741 | $7,871 |
| Ofev | $12,622 | $6,350 |
| Calquence | $14,228 | $8,600 |
| Austedo | $6,623 | $4,093 |
| Otezla | $4,722 | $1,650 |
| Xifaxan | $2,696 | $1,000 |
| Vraylar | $1,376 | $770 |
| Linzess | $539 | $136 |
| Janumet | $526 | $80 |
| Tradjenta | $488 | $78 |
| Breo Ellipta | $397 | $67 |
The 2026 prices, in effect since January 1, 2026
The first ten. Prices are per 30-day supply, and the list price here is the 2023 wholesale acquisition cost, so the comparison year differs from the table above.
| Drug | List | Negotiated |
|---|---|---|
| Imbruvica | $14,934 | $9,319 |
| Stelara | $13,836 | $4,695 |
| Enbrel | $7,106 | $2,355 |
| Entresto | $628 | $295 |
| Jardiance | $573 | $197 |
| Farxiga | $556 | $178 |
| Januvia | $527 | $113 |
| Eliquis | $521 | $231 |
| Xarelto | $517 | $197 |
| NovoLog, Fiasp | $495 | $119 |
What happens next
November 1, 2026
The 2028 negotiation period closed.
By November 30, 2026
CMS must publish the agreed 2028 prices. Last cycle it published on November 25, five days early.
January 1, 2027
The 15 negotiated prices in the 2027 table take effect, and the Part D out-of-pocket cap rises to $2,400.
By March 1, 2027
CMS publishes its written explanation of how it arrived at each 2028 price.
January 1, 2028
The 2028 negotiated prices take effect.
Already have a bill for one of these drugs?
A negotiated price does nothing about a bill you have already been sent, and the bills attached to these drugs, especially the infused ones, are often wrong or reducible. Send yours to CareRoute and we will work to bring it down.
Get my bill reviewedOn Medicare and unsure which plan covers your drugs best? Find My Medicare Plan checks every plan in your county against your prescriptions for a flat $99.
Frequently Asked Questions
Is the negotiated price what I will pay at the pharmacy?
No. It is what Medicare and your Part D plan pay. Your share depends on your plan's tier: coinsurance moves with the negotiated price, a flat copay may not move at all. See the section at the top of this page.
When will the 2028 prices be announced?
By November 30, 2026 at the latest. CMS published the previous cycle's prices on November 25, 2025, so late November is the pattern. We update this page when they land.
Why is my drug not on any of these lists?
Only a small number of drugs qualify. A drug must be among Medicare's highest-spending, must have been approved at least 7 years ago (11 for biologics), and must have no generic or biosimilar competing with it. Certain orphan drugs, low-spend drugs and plasma-derived products are excluded by law. If a generic exists for your drug, that generic is usually already cheaper than any negotiated price would be.
Does this apply to my employer or marketplace plan?
No. Maximum fair prices apply only to Medicare. On commercial insurance your cost comes from your own plan. The upside is that manufacturer copay cards are generally available to you and generally prohibited on Medicare, which often matters more than the list price does.
Can a drug be negotiated twice?
Yes. CMS can reopen a price if the drug's monopoly status changes, a new indication is added, or another negotiation factor materially changes. Tradjenta is the first drug selected for renegotiation, in this 2028 cycle, having been negotiated for 2027.
Related
Sources
- CMS, "Medicare Drug Price Negotiation Program: Selected Drugs for Initial Price Applicability Year 2028" fact sheet, January 2026. Spending, patient counts and all third-cycle milestone dates come from this document.
- CMS, Medicare Drug Price Negotiation Program, Selected Drugs and Negotiated Prices.
- CMS announcement of the second-cycle negotiated prices, November 25, 2025.
- Inflation Reduction Act of 2022, sections establishing the Negotiation Program, including the November 30 publication deadline and the January 1, 2028 applicability date.
How we verify: every price and date on this page is taken from CMS source documents rather than secondary reporting, and the page carries a "last verified" date. The 2028 column shows no prices because none have been published yet. We will not estimate them.
This page is general cost information, not medical, legal or financial advice, and not a recommendation of any drug or plan. Prices change and plan rules vary. Confirm your own costs with your plan, your pharmacy, or Medicare at 1-800-MEDICARE (1-800-633-4227). Never stop or change a prescribed medication because of cost without speaking to your prescriber first.