Medicare Negotiated Drug Prices for 2026 and 2027

How Medicare negotiation works

The Inflation Reduction Act lets Medicare negotiate prices for high-cost drugs that have been on the market for years without generic or biosimilar competition. CMS, the agency that runs Medicare, picks the drugs from the ones Medicare spends the most on, negotiates with each company, and publishes the result. The law calls it the maximum fair price; this article calls it the negotiated price.

Every Medicare drug plan, whether a standalone Part D plan or a Medicare Advantage plan with drug coverage, has to include the drugs with a negotiated price on its list of covered drugs. After the first year, each price rises with inflation. A drug stays in the program until CMS finds that a generic or biosimilar version is on the market; then it leaves, and the negotiated price stops applying.

The 2026 negotiated prices

The first ten prices took effect on January 1, 2026. CMS’s discounts from the 2023 list prices run from 38% (Imbruvica) to 79% (Januvia).

The 2027 negotiated prices

On January 1, 2027, 15 more drugs get negotiated prices. CMS’s discounts from the 2024 list prices run from 38% to 85%. Of the 2026 drugs, 6 stay in the program at an inflation-adjusted price, so 21 drugs have negotiated prices in 2027.

Medicare drug plans cover Wegovy only for certain uses, such as lowering the risk of heart attack and stroke. For weight management alone, the separate Medicare GLP-1 Bridge is the route, and our GLP-1 cost comparison explains it.

Four drugs leave the program in 2027

CMS’s price file ends the negotiated prices for Entresto, NovoLog/Fiasp, Stelara and Xarelto on December 31, 2026. If you take one of them, look up what your plan will charge for it in 2027 instead of assuming this year’s price carries over, and ask your prescriber or pharmacist whether a generic or biosimilar version suits you.

• Stelara: several biosimilars are on the market, each with its own assistance programs. Our Humira and Stelara biosimilars guide lists them.
• NovoLog and Fiasp: Medicare’s $35 monthly cap on covered insulin still applies, negotiated price or not. Our insulin programs guide covers the rest.

What a negotiated price means for what you pay

You do not pay the negotiated price itself. Your plan pays the pharmacy based on it, and you pay your share under your plan’s own rules: the deductible first, then a copay or coinsurance.

• Coinsurance is a percentage of the drug’s price, so a lower price means a lower bill.
• A flat copay is set by your plan and may stay the same.
• The yearly cap still applies. In 2026, the most you pay out of pocket for covered Part D drugs is $2,100, and it rises to $2,400 in 2027. A lower price can mean reaching it later, or not at all.
• Plans still set their own rules. A plan has to cover the drug, but it decides the cost tier, and rules such as prior authorization can still apply.

The simplest way to see the effect for you is to enter your drugs in Medicare’s Plan Finder during open enrollment, which runs until December 7, and compare the yearly totals.

Help that still matters on Medicare

Copay cards do not work with Medicare, and that does not change with negotiation. Free-drug patient assistance can. mendmeds tracks all 23 brands with a 2027 negotiated price, and 8 of them have a maker free-drug program that takes Medicare Part D. The programs for Jardiance and Tradjenta also list Part D, but have stopped taking new Medicare enrollees.

If your income and savings are limited, Extra Help lowers what you pay for every covered drug, and the Medicare Prescription Payment Plan can spread a large bill across the year.

What comes next: the 2028 list

On January 27, 2026, CMS picked 15 more drugs for prices that start in 2028: Anoro Ellipta, Biktarvy, Botox, Cimzia, Cosentyx, Entyvio, Erleada, Kisqali, Lenvima, Orencia, Rexulti, Trulicity, Verzenio, Xeljanz and Xolair. It is the first round to include drugs given in a doctor’s office under Part B, and CMS is also renegotiating Tradjenta’s price. CMS’s data file had no 2028 prices yet when we checked it on November 2, 2026.