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Medicare Part D Prescription Drug Price Negotiations

Diane Andree
Mar 42 min read

Price increases of certain medications have made them unaffordable for some people, especially those on Medicare.  Thank goodness for the new prescription drug law that allows Medicare, for the first time since its inception, to negotiate lower prices for some medications in its prescription drug program (Part D). The first round of price negotiations took place last year and applied to 10 prescription drugs, chosen from a list of 50 of the costliest and most used drugs, that treat conditions such as diabetes, heart disease and arthritis.


The list of the first 10 drugs included Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and for the following for diabetes: Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill.  The lower negotiated prices for these 10 drugs, which will take effect in 2026, are expected to save Medicare prescription drug plan enrollees a collective $1.5 billion in out-of-pocket expenses.


Medicare has chosen the next round of 15 prescription medications to be negotiated, which treat conditions such as cancer, diabetes and asthma, account for about $41 billion in total Medicare Part D spending, and are used by about 5.3 million enrollees. Negotiations will take place through 2025 and the new prices will take effect in 2027. The next 15 prescription drugs picked by Medicare for price negotiations are:  


  • Ozempic; Rybelsus; Wegovy (type 2 diabetes, other indications)

  • Trelegy Ellipta (COPD, asthma)

  • Xtandi (cancer)

  • Pomalyst (cancer)

  • Ibrance (cancer)

  • Ofev (chronic lung diseases)

  • Linzess (inflammatory bowel disease)

  • Calquence (cancer)

  • Austedo; Austedo XR (Huntington’s disease)

  • Breo Ellipta (COPD, asthma)

  • Tradjenta (type 2 diabetes)

  • Xifaxan (irritable bowel syndrome, diarrhea)

  • Vraylar (depression, bipolar disorder, schizophrenia)

  • Janumet; Janumet XR (type 2 diabetes)

  • Otezla (psoriasis, psoriatic arthritis)

 

Up to 15 more drugs will be selected for the third cycle of price negotiations in 2026 and up to 20 more drugs for each annual cycle after that.



 
 
 

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