Medicare’s drug price negotiation program picked its next round of targets in January, and the numbers attached to that list are large by any measure: 15 medications that about 1.8 million people relied on between November 2024 and October 2025, at a combined cost of roughly $27 billion to Medicare Part B and Part D. For anyone managing arthritis, cancer, HIV or a chronic lung condition with one of these drugs, that isn’t an abstract line in a federal budget document — it’s the medicine already in their cabinet or infusion chair, and Medicare’s spending on it is now headed toward a government-negotiated price instead of whatever a manufacturer sets on its own.
Arthritis Biologics, Cancer Drugs And An HIV Treatment Dominate The List
The selected drugs cover conditions that show up constantly among older Medicare enrollees: the psoriasis and arthritis biologics Cosentyx, Cimzia and Orencia; the cancer treatments Kisqali, Lenvima, Erleada and Verzenio; the HIV drug Biktarvy; the Crohn’s and ulcerative colitis drug Entyvio; the COPD inhaler Anoro Ellipta; the asthma and chronic hives drug Xolair; the antipsychotic Rexulti; the diabetes drugs Trulicity and Tradjenta; and Botox and Botox Cosmetic. For the first time, the list mixes drugs a patient picks up at a pharmacy counter with drugs a doctor administers by injection or infusion and bills through Medicare Part B, widening the negotiation program beyond pharmacy-only medications for the first time since it began. That distinction matters for a household’s budget beyond the sticker price: standard Part B cost-sharing runs 20 percent coinsurance with no yearly out-of-pocket cap the way Part D now has one, so a person getting an infused cancer or arthritis drug in a doctor’s office can face a bigger, more open-ended bill than someone filling a prescription at a pharmacy counter.
The companies that make all 15 selected drugs, along with the maker of Tradjenta, which is undergoing the program’s first-ever renegotiation, agreed to participate by a February 28, 2026 statutory deadline, and CMS confirmed that participation on March 13, 2026. None opted out, an option that would have triggered steep excise-tax penalties under the Inflation Reduction Act instead of a negotiated price, and would have left the drug’s price to the manufacturer alone.
Free retirement updates: One number can cost or save hundreds a month in retirement. The free Retirement Shield newsletter surfaces the ones worth knowing. Sign up free.
Twenty-Seven Billion Dollars Works Out To About $15,000 Per Patient
According to CMS’s own accounting, the $27 billion in combined Part B and Part D spending on these 15 drugs represents about 6 percent of everything Medicare spent across both parts during that 12-month stretch — a striking concentration for a list this short, out of the thousands of drugs Medicare covers. Divide the two CMS figures against each other and the spending averages out to roughly $15,000 in Medicare drug costs for every person who used one of the selected drugs that year, a rough measure of scale rather than any one patient’s actual bill, since costs for a cancer infusion or a biologic injection vary widely by dose, diagnosis and how long someone has been on the drug.
That concentration is exactly the point of the selection formula Congress wrote into the Inflation Reduction Act: negotiation targets are picked from among the highest-expenditure drugs without generic or biosimilar competition, so a relatively small list can still move a meaningful share of total Medicare drug spending once new prices take hold.
Manufacturers Signed On In March; Negotiations Run Through The Fall
The calendar behind this round has been running since last year. CMS issued draft guidance for the third negotiation cycle in May 2025 and final guidance on September 30, 2025, then announced the 15 selected drugs and the one renegotiation on January 27, 2026. After manufacturer participation was locked in that March, CMS is required to send each company an initial price offer, with a proposed maximum fair price and justification, no later than June 1, 2026. Companies get 30 days to accept or counter, CMS can call up to two more negotiation meetings through the summer and fall, and the negotiation period itself closes on November 1, 2026.
None of that changes what a pharmacy or infusion center charges Medicare today. Whatever price CMS and each manufacturer land on will not take effect until January 1, 2028, the same lag built into the program’s first two negotiation cycles, and CMS posts the running list of every selected drug and every finalized price, cycle by cycle, on its own negotiation program page.
Until 2028, The Relief On These Drugs Still Has To Be Requested
That two-year runway matters for household budgeting. A person on Cosentyx for psoriatic arthritis, Verzenio for breast cancer or Biktarvy for HIV won’t see a negotiated price show up in their coinsurance this year or next; the coverage and cost-sharing rules that apply to their Part B or Part D plan today are the ones that apply through 2027. The programs that already exist to lower a prescription bill in the meantime — Medicare’s Extra Help subsidy, state pharmaceutical assistance, and Medicare Savings Programs that cover premiums and cost-sharing — don’t attach themselves to a Part B or Part D enrollment automatically. Each one requires its own application, and each has its own income and asset rules that change from state to state — a Medicare Savings Program that covers a Part B premium in one state can carry a noticeably higher asset limit than the same program run next door, and Extra Help’s own income test is separate again.
CMS’s own fact sheet is blunt about the timeline: negotiated prices resulting from this round “will be effective beginning in 2028,” a date the agency has now repeated across three straight negotiation cycles as the fixed point everything else on this list works backward from.
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.
