Medicare’s drug-price negotiation program entered a new phase on January 27, 2026, when the Centers for Medicare & Medicaid Services named 15 more high-cost prescriptions for its third round of price talks, plus one existing drug picked for the program’s first-ever renegotiation. In the first two rounds, every selected drug came out of Part D, the pharmacy side of Medicare’s drug benefit. This round breaks that pattern: several of the newly selected drugs are billed under Part B, the medical benefit that pays for medications a doctor or infusion nurse administers directly, rather than a prescription filled at a pharmacy counter.
The 15 Drugs Selected for the Third Round, and One Up for Renegotiation
CMS’s announcement lists Anoro Ellipta, Biktarvy, Botox and Botox Cosmetic, Cimzia, Cosentyx, Entyvio, Erleada, Kisqali, Lenvima, Orencia, Rexulti, Trulicity, Verzenio, Xeljanz and Xeljanz XR, and Xolair as the 15 selected drugs. Separately, CMS chose Tradjenta, a type 2 diabetes drug already negotiated once for the 2027 pricing cycle, as the program’s first-ever renegotiation candidate. Between them, the 15 newly selected drugs treat cancer, HIV, arthritis, asthma, diabetes and other conditions that, combined, accounted for roughly $27 billion in Medicare Part B and Part D spending and touched about 1.8 million beneficiaries between November 2024 and October 2025 — about 6 percent of all Part B and Part D drug spending in that window. Every manufacturer with a selected drug had until February 28, 2026, to decide whether to participate, and on March 13, 2026, CMS confirmed that all of them, including Tradjenta’s manufacturer, chose to take part in the negotiations.
Free prescription checklist: When a drug’s price or coverage rule changes, the next refill is where it shows up. Get the free coverage and pharmacy checklist.
Why Putting Part B Drugs on the List Changes Who Feels the Price Cut
The distinction between Part B and Part D matters more than it sounds. Part D is the retail pharmacy benefit: a member picks up a prescription at the counter and pays a copay or coinsurance capped annually. Part B is the medical benefit that pays for a drug only when a clinician administers it, typically by injection or infusion in an office or infusion center, and it carries no matching annual out-of-pocket cap — a beneficiary without supplemental coverage generally owes 20 percent coinsurance on the Medicare-approved amount for that visit’s dose, calculated fresh at the point of administration. Six of the third cycle’s 15 drugs carry the billing codes that show they’re used this way: Entyvio (billed under code J3380), Botox and Botox Cosmetic (J0585), Xolair (J2357), Cimzia (J0717), Orencia (J0129) and Cosentyx (J3247), according to CMS’s own top-50 negotiation-eligible drug list. Entyvio, for Crohn’s disease and ulcerative colitis, and Orencia, for rheumatoid and psoriatic arthritis, are typically given as infusions that can run an hour or more in a clinical setting. Botox for chronic migraine or overactive bladder, and Xolair for severe asthma, are injected by a provider rather than self-administered at home. When a negotiated price eventually applies to one of those drugs, the savings show up in the 20 percent coinsurance calculated off that lower price at the office visit, not in a smaller bill at the pharmacy register, which is where every prior negotiated drug’s savings have landed until now.
None of the New Prices Take Effect Before 2028
Selecting a drug for negotiation is not the same as cutting its price today, and nothing about this round changes what anyone pays this year or next. CMS’s own timeline has negotiations running through 2026: manufacturers were required to submit pricing data by March 1, 2026, CMS must send final offers by September 30, 2026, and companies have until October 31, 2026, to accept or reject them before the negotiation period closes November 1, 2026. CMS must publish whatever maximum fair prices come out of that process by November 30, 2026, but even then, those prices don’t take effect until January 1, 2028. That’s a full two years after the drugs were named, and roughly a year behind the program’s second round, where all 15 negotiated prices already took effect January 1, 2027. Anyone reading a headline about 15 more drugs getting cheaper should know the discount is not live yet and, for the Part B drugs on this list, will land in a coinsurance calculation rather than a pharmacy receipt when it finally does. According to CMS’s March 2026 update, that negotiation process, one track for each of the 15 selected drugs plus Tradjenta’s renegotiation, is now underway, with results due before the end of the year.
When The Bill Comes From The Doctor’s Office, Not The Pharmacy
A negotiated price that doesn’t arrive until 2028 does nothing for a household facing a Part B coinsurance bill or a denied prior-authorization request today. Medicare’s medical benefit has no annual cap the way the pharmacy benefit increasingly does, so an infused or injected drug can generate a larger, less predictable bill than the same household expects from a pill picked up at the counter. Tracking what a drug actually costs, and knowing the appeal options when coverage is denied, matters regardless of what happens to any single drug’s price years from now.
The Medicare Cost & Coverage Protection Kit carries the prior-authorization appeal steps for drugs that face coverage denials alongside a medication and cost tracker for logging what a Part B or Part D drug costs from one visit or refill to the next.
Read the new Part D out-of-pocket cap in The Medicare Cost & Coverage Protection Kit.
AI-assisted research and drafting; reviewed by an editor.
