Medicare’s 2026 Drug Price Negotiations: A New Era of Affordability
Starting January 1, 2026, Medicare will implement its first-ever negotiated prescription drug prices; a historic change that could lower costs for millions of beneficiaries. In this post, we discuss Medicare’s 2026 Drug Price Negotiations. This is a direct result of the Inflation Reduction Act of 2022, which for the first time gave Medicare the authority to negotiate the prices of certain high-cost medications.
Why This Matters
For decades, Medicare was prohibited from negotiating directly with drug manufacturers. Instead, it relied on private Part D plan sponsors to manage drug costs. The 2026 negotiations mark a turning point. Medicare will now establish a Maximum Fair Price (MFP) for select drugs, reducing both what the government pays and what beneficiaries spend at the pharmacy counter.
- Projected Medicare savings: About $6 billion in 2026
- Projected out-of-pocket savings for beneficiaries: About $1.5 billion
The First 10 Drugs Negotiated for 2026
CMS chose these drugs because; they are some of the highest-cost Part D medications. In addition; there are no generic or biosimilar medications available, and are widely prescribed.
- Eliquis – blood thinner for preventing stroke and blood clots
- Xarelto – blood thinner for reducing risk of clotting
- Januvia – diabetes medication (DPP-4 inhibitor)
- Jardiance – diabetes, heart failure treatment (SGLT2 inhibitor)
- Farxiga – diabetes, heart failure, kidney disease treatment (SGLT2 inhibitor)
- Entresto – heart failure medication
- Enbrel – rheumatoid arthritis and autoimmune conditions
- Stelara – psoriasis, Crohn’s disease, ulcerative colitis
- Imbruvica – blood cancers (leukemias and lymphomas)
- NovoLog / Fiasp – fast-acting insulin for diabetes
How Beneficiaries Will Benefit
- Lower copays and coinsurance: Out-of-pocket costs will drop for patients taking these medications.
- Broader affordability: Even if you don’t take one of these drugs, Medicare’s overall savings help stabilize Part D premiums.
- Expanded impact in future years: In 2027 and beyond, CMS has scheduled more drugs for negotiation.
Watch a YouTube video on the Inflation Reduction Act and Changes to Medicare
What Comes Next
- 2027: Fifteen more high-spend drugs are already set to be negotiated, with prices effective January 1, 2027.
- 2028 and beyond: CMS will continue expanding the program, selecting additional drugs each year.
- Rulemaking: Starting in 2026, the program shifts to a formal rulemaking process, adding more transparency.
Challenges and Legal Pushback
The pharmaceutical industry has filed multiple lawsuits challenging Medicare’s new authority, arguing that price negotiations are unconstitutional. At the same time, new legislation has delayed or exempted certain blockbuster drugs, such as Keytruda, from early negotiation. While these challenges could affect the program’s scope, the 2026 savings are locked in and moving forward.
What You Should Do
- Review your Medicare Part D plan during open enrollment to ensure it covers your prescriptions at the lowest cost.
- Talk to your agent if you take any of the drugs on the 2026 negotiation list, you could see meaningful savings.
- Stay informed about future negotiation cycles, as more medications are added each year.
Agents:
Click here to fill out an online contract to join the Crowe team
Stay updated on agent events and information
Medicare’s 2026 drug price negotiations represent a historic shift in prescription drug policy. For the first time, Medicare is actively reducing the cost of some of the most expensive and widely used medications in the program. While legal and political challenges remain, the immediate savings for beneficiaries and taxpayers are significant—and this is only the beginning.