Fifteen brand-name medicines used by roughly 5.3 million Medicare Part D enrollees are getting new, government-negotiated prices on January 1, 2027, according to the Centers for Medicare & Medicaid Services. The new prices run from 38 percent to 85 percent below each drug’s 2024 list price and cover treatments for type 2 diabetes, asthma, several cancers, Huntington’s disease and psychiatric conditions. The second round follows the first ten negotiated drugs, whose lower prices already took effect at the start of 2026.
Why These 15 Drugs Were Chosen
CMS published the list on January 17, 2025, selecting the drugs under rules set by the Inflation Reduction Act of 2022. The law directed the agency to identify the highest-spending brand-name drugs that face no generic or biosimilar competition, rank the 50 with the largest total Part D costs, then narrow that group to the 15 with the highest spending after excluding drugs already picked in the first cycle and any granted a small-biotech exception. Four drugs qualified for that exception in this cycle, according to CMS’s selected-drug fact sheet.
The 15 selected drugs accounted for $42.5 billion in Part D spending during 2024, about 15 percent of the program’s total drug costs that year, the same fact sheet reported, with roughly 5.3 million of the program’s 53 million Part D enrollees using at least one of the drugs.
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. See the state cost-help packs in The Medicare Cost & Coverage Protection Kit.
The Medicines and Their New 2027 Prices
The roster covers the semaglutide family sold as Ozempic, Rybelsus and Wegovy, made by Novo Nordisk; GlaxoSmithKline’s inhalers Trelegy Ellipta and Breo Ellipta for asthma and chronic obstructive pulmonary disease; Astellas Pharma’s prostate cancer drug Xtandi; Bristol-Myers Squibb’s Pomalyst for multiple myeloma and Kaposi sarcoma; Pfizer’s breast cancer drug Ibrance; and Boehringer Ingelheim’s Ofev for idiopathic pulmonary fibrosis and Tradjenta for type 2 diabetes. It also includes AbbVie’s Linzess for chronic constipation and Vraylar for bipolar disorder and schizophrenia, AstraZeneca’s Calquence for chronic lymphocytic leukemia, Teva’s Austedo and Austedo XR for Huntington’s chorea, Salix Pharmaceuticals’ Xifaxan for hepatic encephalopathy, Merck’s Janumet and Janumet XR for type 2 diabetes, and Amgen’s Otezla for psoriasis and Behçet’s disease oral ulcers, according to the negotiated-price fact sheet CMS published in November 2025.
Under the agreed prices, a 30-day supply of Ozempic, Rybelsus or Wegovy falls from a $959 list price to $274, a 71 percent cut. Tradjenta drops from $488 to $78, an 84 percent cut, and Janumet or Janumet XR fall from $526 to $80, an 85 percent cut. Xtandi, used by about 35,000 prostate cancer patients, falls from $13,480 to $7,004 for a 30-day supply, a 48 percent reduction, the same fact sheet shows.
How the Two Negotiating Rounds Compare
CMS’s own consumer guide draws the line between the two rounds directly: “Prices for the first 10 Part D drugs that Medicare negotiated became available on January 1, 2026, and prices for the next 15 drugs that Medicare negotiated under Part D take effect on January 1, 2027,” the agency states in its Your Medicare in 2027 publication. The first round was selected in August 2023 and negotiated during 2024. This second round was selected in January 2025 and negotiated through most of 2025, with the negotiation period formally ending November 1, 2025, once CMS and all 15 participating companies reached agreement on a price.
Negotiations That Ran Company by Company
CMS reported that eight of the 15 agreements were reached through negotiation meetings or additional price exchanges, with the company’s counteroffer accepted in seven of those cases. For the remaining seven drugs, CMS issued a written final offer that each company accepted by the October 31, 2025 deadline. Discounts varied by drug: Breo Ellipta fell 83 percent from its 2024 list price, Linzess fell 75 percent, and Calquence, used by an estimated 15,000 leukemia and lymphoma patients, fell 40 percent, the smallest discount on the list, per CMS’s negotiated-price fact sheet. Xifaxan, prescribed for hepatic encephalopathy and irritable bowel syndrome with diarrhea, fell 63 percent, from $2,696 to $1,000 for a 30-day supply, while Ibrance, a breast cancer drug used by about 16,000 enrollees, dropped 50 percent, from $15,741 to $7,871.
What the Discounts Add Up To
Measured against actual 2024 Medicare spending on the 15 drugs, CMS calculated that the negotiated prices would have cut net drug costs by an estimated $12 billion, or about 44 percent, had they already been in place that year. Once the coverage-gap discount program is factored in, the agency put the figure closer to $8.5 billion in savings, or about 36 percent lower net spending. Looking ahead to the first year the new prices actually apply, CMS projected that people enrolled in Medicare prescription drug coverage would save about $685 million in out-of-pocket costs in 2027 under the program’s standard benefit design, according to the negotiated-price fact sheet.
What Happens Before the January Start Date
Each participating company must make its negotiated price available to eligible individuals and to the pharmacies, mail-order services and other entities that dispense the drug, and every Medicare prescription drug plan and Medicare Advantage-prescription drug plan must include in its formulary any selected drug for which a price was agreed to, according to CMS’s Selected Drugs and Negotiated Prices page. CMS has said it will publish a public explanation of how each price was reached by March 2026. After the prices take effect, CMS will update each one annually by the change in the Consumer Price Index for all urban consumers, unless a price is renegotiated sooner. A third round of negotiations, covering drugs with prices effective in 2028, is already underway under final guidance CMS issued on September 30, 2025.
Negotiated Prices at the Pharmacy Counter
A negotiated price only reaches a household once a plan’s formulary, a pharmacy’s system and a prior-authorization rule all line up behind it, and that handoff is where the savings above can quietly get lost. Enrollees switching plans during the next open enrollment, or appealing a plan’s coverage decision on one of these drugs, are working through paperwork the CMS fact sheets above don’t cover.
The Medicare Cost & Coverage Protection Kit is a 10-page kit that includes the prior-authorization appeal steps and a medication and cost tracker for keeping new prices and refill dates straight.
See the prior-authorization appeal steps and cost tracker in The Medicare Cost & Coverage Protection Kit.
AI-assisted research and drafting; reviewed by an editor.
