The Centers for Medicare & Medicaid Services has a hard date circled on its calendar: November 30, 2026. By then, the agency must publish the negotiated prices it reaches with drug companies over 15 more high-cost medications, the third round of price negotiations created by the Inflation Reduction Act. For the first time, the list includes drugs that patients don’t pick up at a pharmacy counter — they receive them by infusion or injection in a doctor’s office, billed through Medicare Part B. For older adults managing arthritis, psoriasis, cancer or other chronic conditions, the drugs on this list aren’t abstract line items; they’re the treatments keeping them functional, and the coinsurance on them is real money.
Fifteen Drugs Move Into the Third Negotiation Round
The third cycle’s selected list, announced in January, mixes familiar brand names with new territory for the negotiation program. It includes the asthma and chronic hives drug Xolair, the psoriasis and arthritis biologics Cosentyx and Cimzia, the diabetes drug Trulicity, the cancer treatments Kisqali, Lenvima, Erleada and Verzenio, the Crohn’s and colitis drug Entyvio, the rheumatoid arthritis drug Orencia, the COPD inhaler Anoro Ellipta, the antipsychotic Rexulti, the HIV drug Biktarvy, and Botox and Botox Cosmetic. CMS also chose one drug that already went through a prior negotiation, the diabetes drug Tradjenta, for the program’s first-ever renegotiation — a second look allowed once a drug’s role in the Medicare population changes enough to justify revisiting its price.
Between November 2024 and October 2025, roughly 1.8 million people with Medicare Part D or Part B coverage used these 15 drugs to treat conditions including cancer, psoriatic arthritis and HIV, according to CMS. Combined, the drugs accounted for about $27 billion in Medicare Part B and Part D spending during that stretch, or roughly 6 percent of total spending across both parts — the kind of scale that explains why this particular list, out of thousands of drugs Medicare covers, was the one selected for negotiation.
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Why “Doctor-Administered” Changes Who Feels the Difference
Every drug in the first two negotiation cycles was a pharmacy drug, billed under Part D and picked up with a card at the counter. The third cycle is the first to reach into Part B, which covers drugs a clinician administers directly — infusions for Entyvio and Orencia, injections for Cosentyx, Cimzia and Xolair, and Botox given during an office visit rather than filled as a prescription. That distinction matters for household budgets because Part B and Part D cost-sharing work differently: Part B coinsurance is typically a percentage of the drug’s price, while Part D plans more often use fixed copays or a capped annual out-of-pocket limit.
How much a lower negotiated price on a Part B drug actually changes what a patient owes in the exam room will depend on the final maximum fair prices, which CMS has not yet made public and will not until the process concludes later in 2026.
The Countdown From November 1 to November 30
The nine months between the January drug selection and the price-publication deadline follow a fixed script written into the negotiation program’s calendar. Manufacturers had until February 28, 2026, to agree to participate; CMS has confirmed all of them did. Manufacturers then submitted data in March, CMS is required to send initial price offers by June 1, and manufacturers have until July 1 to accept or counter. Negotiation meetings continue through the summer, CMS’s final offer is due by September 30, 2026, manufacturers must accept or reject it by October 31, and the negotiation period itself ends November 1, 2026.
That sequence leaves a single hard date left standing: November 30, 2026, the deadline for CMS to publish whatever maximum fair prices come out of that process for the 15 selected drugs and Tradjenta’s renegotiation. The new prices don’t take effect immediately — they become the prices Medicare pays starting January 1, 2028 — but the publication deadline itself doesn’t move, which is why it’s already fixed on the calendar more than a year before it arrives.
What the Last Round of Negotiated Prices Actually Saved
The second negotiation cycle, covering 15 Part D drugs with prices taking effect January 1, 2027, reached agreements with every manufacturer involved. CMS has estimated that if those newly negotiated prices had applied in 2024, they would have cut net covered prescription drug spending on those drugs by about $8.5 billion, roughly 36 percent lower net spending in aggregate, according to the same CMS announcement covering the third cycle’s selection. That’s the only completed round of savings data the program has produced so far, and it won’t gain a second data point until the third cycle’s negotiated prices actually publish on November 30.
Manufacturers Are In, But the Price Isn’t Set Yet
CMS confirmed on March 13, 2026, that the drug companies behind all 15 selected drugs, plus Tradjenta’s manufacturer, signed agreements to participate in the Negotiation Program, according to CMS’s negotiated-prices page. That participation confirmation isn’t the same as a finished deal — it means the companies are required to negotiate, not that any price has been agreed to. The actual maximum fair prices, the numbers that eventually flow into what Medicare and its beneficiaries pay starting in 2028, are still being worked out through the summer and fall negotiation rounds CMS has scheduled for 2026.
CMS has also committed to publishing a narrative explanation of the negotiation process alongside the agreed prices by March 1, 2027 — the same transparency step it took after the first two cycles, when it released detailed explanations of how each price was reached. Until the November 30 deadline arrives, the only certainty is the one already written into the program’s calendar: prices for 15 more drugs, some delivered in a doctor’s office rather than picked up at a pharmacy, are due before the year is out.
Where the help is written down
The programs that lower Medicare costs each run on a different form and a different office, and no single notice lists them together.
The Medicare Cost & Coverage Protection Kit includes a 10-page kit, 51 state Medicare cost-help packs and the new Part D out-of-pocket cap.
See the state cost-help packs in The Medicare Cost & Coverage Protection Kit.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
