The Latest Maximum Fair Prices for Medicare-Negotiated Drugs

The Centers for Medicare & Medicaid Services (CMS) announces negotiated Medicare drug prices for common and expensive drugs used by beneficiaries.

As a result of the negotiations, many individuals will see significant out-of-pocket savings!

CMS Announces 2028 Maximum Fair Prices for 15 New Medicare-Negotiated Drugs Under Part B & D

On January 27, 2026, the Centers for Medicare & Medicaid Services (CMS) announced lower costs for an additional 15 drugs used to treat cancer and other chronic diseases.

Effective January 1, 2028, the Maximum Fair Prices (MFPs) for the next 15 Medicare-negotiated drugs brings the total number of negotiated drugs to 40.

2028 List of Selected Drugs for Negotiation

Drug NameCommonly Treated ConditionsTotal Medicare Part B and Part D Prescription Drug Expenditures from November 2024-October 2025Number of Medicare Beneficiaries Who Used the Drug from November 2024-October 2025
TrulicityType 2 diabetes; Type 2 diabetes and cardiovascular disease or multiple cardiovascular risk factors$4,898,378,000617,000
BiktarvyHuman immunodeficiency virus type 1 infection$3,904,486,000101,000
OrenciaPsoriatic arthritis; Rheumatoid arthritis$2,450,065,00072,000
CosentyxPlaque psoriasis; Psoriatic arthritis$2,327,442,00040,000
ErleadaProstate cancer$1,947,504,00019,000
KisqaliBreast cancer$1,578,679,00017,000
EntyvioCrohn’s diseasel; Ulcerative colitis$1,483,348,00037,000
VerzenioBreast cancer$1,428,714,00015,000
Botox; Botox Cosmetic*Chronic migraine; Overactive bladder; Spasticity; Other movement disorders$1,143,070,000390,000
LenvimaThyroid cancer; Endometrial cancer; Liver cancer; Kidney cancer$1,088,498,00010,000
XolairAsthma; Chronic spontaneous urticaria$1,077,271,00040,000
RexultiMajor depressive disorder; Schizophrenia; Agitation associated with dementia due to Alzheimer’s disease$1,075,274,000119,000
Xeljanz; Xeljanz XRPsoriatic arthritis; Rheumatoid arthritis; Ulcerative colitis$1,013,332,00022,000
Anoro ElliptaChronic obstructive pulmonary disease$812,772,000281,000
CimziaChron’s disease; Plaque psoriasis; Psoriatic arthritis; Rheumatoid arthritis$786,790,00038,000

Source: CMS.gov
Note: Numbers are rounded to nearest thousands. Conditions listed under commonly treated conditions are limited to conditions for which prescription drug coverage or payment is currently available under the Medicare Part B and/or D program and is not intended to be exhaustive.
*The selected drug name reflects the manufacturer’s naming convention, and use of the manufacturer’s assigned name when describing the selected drug is not indicative of any change in Medicare coverage or payment for this selected drug when used for cosmetic purposes.

CMS Announces Part D Savings & 2027 Maximum Fair Prices for 15 New Medicare-Negotiated Drugs

On November 25, 2025, CMS announced lower costs for 15 drugs used to treat cancer and other chronic diseases.

Effective January 1, 2027, the MFPs for the next 15 Medicare-negotiated drugs brings the total number of negotiated drugs to 25.

2027 Maximum Fair Prices for Medicare-Negotiated Drugs

Drug Name
Participating Manufacturer
Commonly Treated ConditionsNumber of Medicare Beneficiaries Who Used the Drug in 2024Drug List Price for a 30-Day Supply in 2024Negotiated Drug List Price for a 30-Day Supply in 2027Savings
Ozempic; Rybelsus; Wegovy
Novo Nordisk Inc.
Type 2 diabetes; Cardiovascular disease; Obesity/overweight2,282,000$959$274$685 (71%)
Trelegy Ellipta
GlaxoSmithKline Intellectual Property Development Ltd. England
Asthma; chronic obstructive pulmonary disease1,269,000$654$175$479 (73%)
Xtandi
Astellas Pharma US, Inc.
Prostate cancer35,000$13,480$7,004$6,476 (48%)
Pomalyst
Bristol-Myers Squibb Company
Kaposi sarcoma; Multiple myeloma14,000$21,744$8,650$13,094 (60%)
Ofev
Boehringer Ingelheim Pharmaceuticals, Inc.
Idiopathic pulmonary fibrosis24,000$12,622$6,350$6,272 (50%)
Ibrance
Pfizer Inc.
Breast cancer16,000$15,741$7,871$7,870 (50%)
Linzess
AbbVie Inc.
Chronic idiopathic constipation; Irritable bowel syndrome with constipation632,000$539$136$403 (75%)
Calquence
AstraZeneca UK Limited
Chronic lymphocytic leukemia/small lymphocytic lymphoma; Mantle cell lymphoma15,000$14,228$8,600$5,628 (40%)
Austedo; Austedo XR
Teva Branded Pharmaceutical Products R&D LLC
Chorea in Huntington’s disease; Tardive dyskinesia27,000$6,623$4,093$2,530 (38%)
Breo Ellipta
GlaxoSmithKline Intellectual Property Development Ltd. England
Asthma; chronic obstructive pulmonary disease626,000$397$67$330 (83%)
Xifaxan
Salix Pharmaceuticals Inc.
Hepatic encephalopathy; Irritable bowel syndrome with diarrhea105,000$2,696$1,000$1,696 (63%)
Vraylar
AbbVie Inc.
Bipolar I disorder; Major depressive disorder; Schizophrenia118,000$1,376$770$606 (44%)
Tradjenta
Boehringer Ingelheim Pharmaceuticals, Inc.
Type 2 diabetes274,000$488$78$410 (84%)
Janumet; Janumet XR
Merck Sharp & Dohme LLC
Type 2 diabetes239,000$526$80$446 (85%)
Otezla; Otezla XR
Amgen Inc.
Oral ulcers in Behçet’s Disease; Plaque psoriasis; Psoriatic arthritis31,000$4,722$1,650$3,072 (65%)

Source: CMS.gov

CMS Announces Part D Savings & 2026 Maximum Fair Prices for First 10 Medicare-Negotiated Drugs

On August 15, 2024, CMS announced the negotiated 2026 Medicare drug prices for 10 common and expensive drugs used by beneficiaries.

In 2023, CMS selected the first 10 drugs Medicare would negotiate the price of with manufacturers. According to the Medicare drug price negotiation timeline, conversations ended August 1, 2024.

The table below features the negotiated Medicare drug Maximum Fair Prices (MFPs) for the first 10 drugs in the Medicare Drug Price Negotiation Program. All of which are among those with the highest total spending in Medicare Part D.

Beneficiaries can benefit from hundreds to thousands of dollars in savings on 30-day supplies. Price reductions for the 2026 group drugs in the Medicare Drug Price Negotiation Program span from 38 percent to 79 percent.

2026 Maximum Fair Prices for Medicare-Negotiated Drugs

Drug Name
Participating Manufacturer
Commonly Treated ConditionsNumber of Medicare Beneficiaries Who Used the Drug in 2023Drug List Price for a 30-Day Supply in 2023Negotiated Drug List Price for a 30-Day Supply in 2026Savings
Eliquis
Bristol Myers Squibb
Prevention and treatment of blood clots3,928,000$521$231$290 (-56%)
Enbrel
Immunex Corporation
Rheumatoid arthritis; Psoriasis; Psoriatic arthritis48,000$7,106$2,355$4,751 (-67%)
Entresto
Novartis Pharms Corp
Heart failure664,000$628$295$333 (-53%)
Farxiga
AstraZeneca AB
Diabetes; Heart failure; Chronic kidney disease994,000$556$178.50$377.50 (-68%)
Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill
Novo Nordisk Inc
Diabetes785,000$495$119$376 (-76%)
Imbruvica
Pharmacyclics LLC
Blood cancers17,000$14,934$9,319$5,615 (-38%)
Januvia
Merck Sharp Dohme
Diabetes843,000$527$113$414 (-79%)
Jardiance
Boehringer Ingelheim
Diabetes; Heart failure1,883,000$573$197$376 (-66%)
Stelara
Janssen Biotech, Inc.
Psoriasis; Psoriatic arthritis; Crohn’s disease; Ulcerative colitis23,000$13,836$4,695$9,141 (-66%)
Xarelto
Janssen Pharms
Prevention and treatment of blood clots; Reduction of risk for patients with coronary or peripheral artery disease1,324,000$517$197$320 (-62%)

Sources: Whitehouse.gov and CMS.gov

How Long Will Medicare-Negotiated Drug Discounts Be in Effect?

If a drug remains in the Medicare Drug Price Negotiation Program, a discount will apply.

For every year a drug remains in the program, CMS will adjust the price by the annual percentage increase in the Consumer Price Index for all urban consumers. The cost may also include any other updates based on renegotiations between CMS and drug manufacturers.

Do Manufacturers Have to Participate in the Medicare Drug Price Negotiation Program?

No. The participation of drug companies in the program is voluntary.

Participating manufacturers must ensure the negotiated price is available to eligible individuals, pharmacies, mail-order services, and other entities that dispense the selected drug.

The Future of Medicare Drug Price Negotiation

On June 12, CMS released a proposed rule to formalize and extend the Medicare Drug Price Negotiation Program starting in 2029 and beyond.

Currently implemented through temporary guidance, the program would transition to a permanent regulatory structure under this rule.

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As the number of negotiated drugs is set to keep increasing, your Medicare clients affected chronic or critical illnesses may keep benefitting! Ensure that your clients are aware of these and any upcoming changes that could affect their prescription drug costs.

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