Updated April 2026 · Source: CMS Medicare Drug Price Negotiation Program
Medicare Negotiated Drug Prices 2026-2027
For the first time in history, Medicare can negotiate prescription drug prices directly with manufacturers. Under the Inflation Reduction Act, 25 drugs now have Maximum Fair Prices — saving Medicare an estimated $13B per year. The average discount is 52% off the prior price.
Round 1 — Effective 2026 (10 drugs)
Prices announced August 15, 2024. Estimated annual savings: $6.0B.
| Drug | Condition | Prior Price | Negotiated Price | Discount |
|---|---|---|---|---|
| Januvia Sitagliptin | Diabetes | $527.00 | $113.00 | -79% |
| Fiasp/NovoLog Insulin Aspart | Diabetes (Insulin) | $495.00 | $119.00 | -76% |
| Farxiga Dapagliflozin | Diabetes / Heart Failure / Kidney Disease | $556.00 | $178.00 | -68% |
| Enbrel Etanercept | Autoimmune Diseases | $7,106.00 | $2,355.00 | -67% |
| Jardiance Empagliflozin | Diabetes / Heart Failure | $573.00 | $197.00 | -66% |
| Stelara Ustekinumab | Autoimmune Diseases | $13,836.00 | $4,695.00 | -66% |
| Xarelto Rivaroxaban | Blood Clots / Stroke Prevention | $517.00 | $197.00 | -62% |
| Eliquis Apixaban | Blood Clots / Stroke Prevention | $521.00 | $231.00 | -56% |
| Entresto Sacubitril/Valsartan | Heart Failure | $628.00 | $295.00 | -53% |
| Imbruvica Ibrutinib | Blood Cancers | $14,934.00 | $9,319.00 | -38% |
Round 2 — Effective 2027 (15 drugs)
Prices announced November 26, 2025. Estimated annual savings: $7.4B.
| Drug | Condition | Prior Price | Negotiated Price | Discount |
|---|---|---|---|---|
| Wegovy Semaglutide (weight) | Obesity | $1,349.00 | $274.00 | -80% |
| Ozempic Semaglutide (diabetes) | Diabetes | $969.00 | $274.00 | -71% |
| Rybelsus Semaglutide (oral) | Diabetes | $936.00 | $274.00 | -71% |
| Trelegy Ellipta Fluticasone/Umeclidinium/Vilanterol | Asthma/COPD | $586.00 | $305.00 | -48% |
| Repatha Evolocumab | High Cholesterol | $1,145.00 | $620.00 | -46% |
| Vraylar Cariprazine | Mental Health | $1,010.00 | $565.00 | -44% |
| Nurtec ODT Rimegepant | Migraine | $951.00 | $538.00 | -43% |
| Kerendia Finerenone | Kidney Disease / Diabetes | $632.00 | $372.00 | -41% |
| Nucala Mepolizumab | Severe Asthma | $3,396.00 | $2,150.00 | -37% |
| Cosentyx Secukinumab | Autoimmune Diseases | $6,267.00 | $3,980.00 | -37% |
| Calquence Acalabrutinib | Blood Cancers | $14,727.00 | $9,531.00 | -35% |
| Dupixent Dupilumab | Autoimmune (Eczema/Asthma) | $3,601.00 | $2,459.00 | -32% |
| Rinvoq Upadacitinib | Autoimmune Diseases | $5,960.00 | $4,100.00 | -31% |
| Biktarvy Bictegravir/Emtricitabine/TAF | HIV | $3,836.00 | $2,700.00 | -30% |
| Skyrizi Risankizumab | Autoimmune Diseases | $5,855.00 | $4,098.00 | -30% |
Medicare Drug Price Negotiation Timeline
How Medicare Drug Price Negotiation Works
The Inflation Reduction Act of 2022 authorized Medicare to negotiate prices for drugs that meet specific criteria: they must be among the highest-spend drugs in Medicare Part D or Part B, have been on the market for at least 7 years (13 years for biologics), and have no generic or biosimilar competition.
CMS negotiates a Maximum Fair Price (MFP) with each manufacturer. If the manufacturer refuses to negotiate, they face an excise tax of up to 95% of the drug's US sales. The negotiated prices apply to Medicare beneficiaries and are reflected in lower copays and coinsurance.
The program will expand over time: CMS selects 15 additional drugs for negotiation in each subsequent year, eventually covering 60+ drugs by 2029.
Frequently Asked Questions
Medicare has negotiated prices for 25 drugs in two rounds under the Inflation Reduction Act. Round 1 (2026) covers 10 drugs including Eliquis, Jardiance, and Xarelto. Round 2 (2027) covers 15 drugs including Ozempic, Wegovy, and Dupixent. Average discount: 52%.
The Congressional Budget Office estimates $100 billion in savings over 10 years. Annual savings are approximately $13 billion from the first 25 drugs alone. Individual beneficiaries will see lower copays and coinsurance.
Round 1 prices (10 drugs) took effect January 1, 2026. Round 2 prices (15 drugs) take effect January 1, 2027. CMS will select additional drugs for Round 3 in 2027.
Yes — if you are a Medicare Part D beneficiary, the negotiated Maximum Fair Price applies automatically. Your plan must offer the drug at the negotiated price, and your copay or coinsurance will be calculated on the lower amount.
Keytruda and Opdivo are immune checkpoint inhibitors approved for multiple cancer types. They were excluded from Round 1 and Round 2 selection due to the orphan drug exclusion provision in the Inflation Reduction Act, which exempts drugs that only have orphan drug designations. However, future legislative changes may close this loophole.