Medicare's First Negotiated Drug Prices Are Now in Effect for 2026

A change seniors have waited years for is now in force. Since January 1, 2026, Medicare has been paying prices it negotiated directly with drug companies for 10 of the most heavily used prescription medicines in Part D. It is the first time in the program's history that Medicare has set prices at the bargaining table rather than accepting whatever list price a manufacturer named.

The 10 drugs treat conditions that touch millions of older adults: blood clots, diabetes, heart failure, arthritis, and cancer among them. About 8.8 million people with Part D coverage filled prescriptions for these drugs in 2023, according to the Centers for Medicare and Medicaid Services. The new prices run 38 to 79 percent below what the same drugs listed for in 2023.

What actually changed on January 1

The authority comes from the Inflation Reduction Act of 2022, which for the first time let Medicare negotiate the price of certain expensive drugs that have no generic or biosimilar competitor. CMS picked the first 10, spent 2024 negotiating with each manufacturer, and announced final prices in August 2024. Those prices, which the law calls maximum fair prices, became the amount Medicare and its drug plans pay starting this year.

This is a real, in-effect benefit change, not a proposal or a forecast. The prices are locked for 2026. What is still moving is the program's expansion: a second group of 15 drugs has already been negotiated for 2027, and more follow every year after that.

The 10 drugs and their new prices

The table below shows each drug, the negotiated price for a standard 30-day supply in 2026, the 2023 list price it replaces, and the discount. Prices are from the CMS fact sheet published in 2024.

Eliquis, a blood thinner, was the most widely used of the group, filled by nearly 3.9 million Medicare enrollees in 2023. Jardiance, for diabetes and heart failure, reached about 1.9 million. Together the 10 drugs accounted for $56.2 billion in Part D drug spending in 2023, roughly a fifth of the program's total.

Whether you will actually pay less

Here is the part worth reading slowly, because a lower negotiated price does not automatically become a lower pharmacy bill for every patient. The maximum fair price is what Medicare and your drug plan pay for the drug. What you pay at the counter is your plan's cost sharing, which can be a flat copay or a percentage of the drug's price.

If your plan charges a percentage, called coinsurance, a lower drug price lowers your share directly. If your plan charges a flat copay, your copay may not move much, but the lower price still slows how fast you reach your deductible and your out-of-pocket cap. CMS projects people with Part D coverage will save about $1.5 billion in out-of-pocket costs across these drugs in 2026.

The negotiated prices stack on top of another 2026 change: Part D now caps what you pay out of pocket for covered drugs at $2,100 for the year, up from $2,000 in 2025. Once your spending hits that ceiling, you pay nothing more for covered drugs for the rest of the year. If a fixed income makes even the run-up to that cap hard, check whether you qualify for Medicare Savings Programs and Extra Help, which can erase premiums and slash drug copays for people who meet the income limits.

How to tell if one of your drugs is on the list

Look at your prescription bottles and match the brand name against the table above. The negotiated price applies to the brand-name drug; if you already take a generic, this program does not change your cost, because these 10 drugs were chosen precisely because they have no generic competition yet. If a drug you take is on the list, your 2026 plan documents, the Explanation of Benefits, and your pharmacy receipt will reflect the price your plan pays.

One caution for people in Medicare Advantage or standalone Part D plans: plans still set their own formularies and cost-sharing tiers. The negotiated price is a floor for what the plan pays, not a fixed copay for you. If your out-of-pocket cost looks wrong, call your plan and ask how the maximum fair price is being applied.

What changes in 2027: 15 more drugs, including Ozempic

The program grows next year. CMS selected a second group of 15 Part D drugs and, in late November 2025, published the prices that take effect on January 1, 2027. The one most people will recognize: the semaglutide drugs Ozempic, Rybelsus, and Wegovy, used for type 2 diabetes, cardiovascular risk, and obesity, were negotiated down to $274 for a 30-day supply, a 71 percent cut from their $959 list price.

The other 2027 drugs include Trelegy Ellipta, Breo Ellipta, and Ofev for lung conditions; the cancer drugs Xtandi, Pomalyst, Ibrance, and Calquence; the diabetes drugs Janumet and Tradjenta; the gut drugs Linzess and Xifaxan; plus Austedo, Vraylar, and Otezla. CMS says about 5.3 million enrollees used these 15 drugs, which carried $42.5 billion in Part D spending in 2024. Those prices are set but do not take effect until 2027, so they do not change your 2026 costs.

If you take a GLP-1 drug or are weighing one, our guide to GLP-1 drugs for seniors walks through current Medicare coverage rules, which still hinge on why the drug is prescribed.

What to do now

There is nothing to sign up for. If you take one of the 10 drugs, the lower price is already built into your 2026 plan. The useful steps are practical: match your prescriptions against the list, ask your plan how your copay is calculated if it seems high, and, during open enrollment this fall, compare plans with your specific drugs in mind, since a plan's tier design can matter as much as the negotiated price.

For the broader set of programs that stretch a fixed income, see our roundups of senior benefit changes for 2026 and food benefits many seniors miss.

Where this leaves you: Medicare negotiated prices are real, they are in effect for 10 major drugs in 2026, and they expand to 15 more in 2027. How much lands in your pocket depends on your plan, so the drugs on your own shelf are the place to start.

This article is a news report for general information and is not medical or financial advice. Drug prices, plan cost sharing, and program rules change. Confirm your own costs with your Part D or Medicare Advantage plan and with Medicare.