Medicare Drug Price Negotiations: The First 10 Drugs on the List

For the first time in history, Medicare has the power to negotiate prices directly with pharmaceutical manufacturers. This change is set to reshape healthcare expenses for millions of older Americans. While the negotiated prices for the first 10 drugs were announced recently, the actual savings at the pharmacy counter will officially begin on January 1, 2026.

The Historic Shift in Medicare Policy

The Inflation Reduction Act authorized Medicare to negotiate prices for high-cost prescription drugs. Before this law passed, Medicare was legally prohibited from bargaining for lower rates, a restriction that kept prices for common medications significantly higher in the United States compared to other countries.

The Centers for Medicare & Medicaid Services (CMS) selected the first 10 drugs based on their high total cost to the Medicare Part D program. These medications are used by nearly 9 million seniors to treat common but serious conditions like diabetes, heart failure, and blood clots. The government estimates these new “maximum fair prices” will save Medicare approximately $6 billion in the first year alone. For seniors, this translates to an estimated $1.5 billion reduction in out-of-pocket costs.

Breakdown of the First 10 Negotiated Drugs

The negotiations concluded in August 2024. The new prices apply specifically to the 30-day supply of these medications. Here are the specific details on the drugs, their uses, and the new pricing structure taking effect in 2026.

1. Eliquis (Apixaban)

  • Manufacturer: Bristol Myers Squibb / Pfizer
  • Primary Use: Prevention of stroke and blood clots (blood thinner).
  • Negotiated Price: $231
  • Previous List Price: $521
  • Discount: 56%

Eliquis is a critical focus of this program because it was the costliest drug for Medicare Part D in recent years. In 2023 alone, more than 3.9 million Medicare enrollees took this medication. The new price cap of $231 drastically reduces the baseline cost used to calculate beneficiary coinsurance.

2. Jardiance (Empagliflozin)

  • Manufacturer: Boehringer Ingelheim / Eli Lilly
  • Primary Use: Type 2 diabetes and heart failure.
  • Negotiated Price: $197
  • Previous List Price: $573
  • Discount: 66%

Jardiance is widely prescribed to manage blood sugar levels and reduce the risk of cardiovascular death. With a 66% reduction in the list price, patients who pay a percentage of the drug’s cost (coinsurance) will see immediate relief.

3. Xarelto (Rivaroxaban)

  • Manufacturer: Johnson & Johnson
  • Primary Use: Prevention of stroke and blood clots.
  • Negotiated Price: $197
  • Previous List Price: $517
  • Discount: 62%

4. Januvia (Sitagliptin)

  • Manufacturer: Merck
  • Primary Use: Type 2 diabetes.
  • Negotiated Price: $113
  • Previous List Price: $527
  • Discount: 79%

Januvia saw the steepest percentage discount among the initial group. A 79% drop in the base price makes this essential diabetes management tool significantly more accessible.

5. Farxiga (Dapagliflozin)

  • Manufacturer: AstraZeneca
  • Primary Use: Type 2 diabetes, heart failure, and chronic kidney disease.
  • Negotiated Price: $178.50
  • Previous List Price: $556
  • Discount: 68%

6. Entresto (Sacubitril/Valsartan)

  • Manufacturer: Novartis
  • Primary Use: Heart failure.
  • Negotiated Price: $295
  • Previous List Price: $628
  • Discount: 53%

7. Enbrel (Etanercept)

  • Manufacturer: Amgen
  • Primary Use: Rheumatoid arthritis and psoriasis.
  • Negotiated Price: $2,355
  • Previous List Price: $7,106
  • Discount: 67%

8. Imbruvica (Ibrutinib)

  • Manufacturer: AbbVie / Johnson & Johnson
  • Primary Use: Blood cancers (Leukemia/Lymphoma).
  • Negotiated Price: $9,319
  • Previous List Price: $14,934
  • Discount: 38%

9. Stelara (Ustekinumab)

  • Manufacturer: Johnson & Johnson
  • Primary Use: Psoriasis, Crohn’s disease, ulcerative colitis.
  • Negotiated Price: $4,695
  • Previous List Price: $13,836
  • Discount: 66%

10. Fiasp and NovoLog (Insulin Aspart)

  • Manufacturer: Novo Nordisk
  • Primary Use: Diabetes (Insulin).
  • Negotiated Price: $119
  • Previous List Price: $495
  • Discount: 76%

How This Impacts Your Wallet in 2026

Understanding how these negotiated prices translate to your bank account requires looking at how Medicare Part D works. The “Negotiated Price” is the amount Medicare pays the drug maker. It is not necessarily the flat copay you hand the pharmacist, but it directly influences what you pay.

Lower Coinsurance

Many Medicare Part D plans charge “coinsurance” rather than a flat copay for expensive branded drugs. This means you pay a percentage of the drug’s cost (often 25%).

  • Old Scenario (Jardiance): If your plan charged 25% of the $573 list price, you paid roughly $143 per month.
  • New Scenario (Jardiance): With the price negotiated down to $197, your 25% share drops to about $49 per month.

The $2,000 Out-of-Pocket Cap

It is vital to view these price negotiations alongside another major change. Starting in 2025 (one year before these specific drug prices take effect), there is a $2,000 annual cap on out-of-pocket prescription costs for all Medicare beneficiaries.

This means that even if you take expensive medications like Imbruvica (negotiated price: $9,319), you will never pay more than $2,000 total for all your prescriptions in a single calendar year. The price negotiations help the government and taxpayers save money to sustain the Medicare program, while the $2,000 cap directly protects your household budget.

Future Negotiations: What Comes Next?

This list of 10 drugs is only the beginning. The Inflation Reduction Act mandates that CMS continue to negotiate prices for more drugs every year. This creates a rolling schedule of cost reductions:

  • 2027: Negotiations will expand to include 15 more Medicare Part D drugs.
  • 2028: The list grows by another 15 drugs (including Part B drugs administered by doctors).
  • 2029 and beyond: CMS will negotiate prices for 20 additional drugs every year.

This cumulative approach aims to target the most expensive medications that have been on the market for years without generic competition.

Frequently Asked Questions

When will I see the lower prices for Eliquis and Jardiance? The negotiated prices officially take effect on January 1, 2026. Until then, current pricing and your specific Part D plan coverage rules apply.

Do these prices apply to people with private insurance? No. These negotiated prices currently apply only to Medicare beneficiaries. However, market analysts believe that lower Medicare prices could eventually influence private insurers to demand better rates from manufacturers.

Will I still have a copay? Yes. You will still be responsible for copays or coinsurance as determined by your specific Part D plan. However, because the base price of the drug is lower, your percentage-based costs will decrease. Furthermore, you will not pay more than $2,000 out-of-pocket for prescriptions in a year starting in 2025.

Why were these specific 10 drugs chosen? CMS selected these drugs because they had the highest total spending in Medicare Part D (retail prescription drugs) and have no generic or biosimilar competition. They are single-source brand-name drugs that have been on the market for at least 7 years (or 11 years for biologics).