January 28, 2026
Finance

Medicare Expands Drug Price Negotiation Program to Include Part B Medications

Fifteen High-Cost Drugs Selected for Third Cycle as Price Discussions Set for 2026 Implementation in 2028

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Summary

The Centers for Medicare & Medicaid Services (CMS) has unveiled the third cycle of the Medicare Drug Price Negotiation Program, which for the first time incorporates drugs reimbursed under Medicare Part B along with Part D medications. Fifteen expensive prescription drugs, treating conditions from cancer to autoimmune diseases and HIV, are targeted for negotiation. Price discussions with manufacturers will occur in 2026, with adjustments effective January 2028. CMS also selected one previously negotiated drug for its initial renegotiation cycle.

Key Points

CMS has selected 15 high-cost drugs for the third cycle of the Medicare Drug Price Negotiation Program, marking inclusion of Medicare Part B drugs for the first time alongside Part D drugs.
Negotiations with manufacturers are scheduled for 2026, with any new pricing effective on January 1, 2028.
The program targets drugs treating conditions such as cancer, HIV-1, psoriatic arthritis, autoimmune diseases, and severe allergic conditions, aimed at reducing drug costs for seniors and taxpayers.
CMS also listed 50 negotiation-eligible drugs ranked by spending, with the top 15 selected for this cycle representing the highest expenditures under Medicare Parts B and D combined.

The Centers for Medicare & Medicaid Services (CMS) has announced the list of 15 high-expenditure prescription drugs selected for the third iteration of the Medicare Drug Price Negotiation Program. Notably, this cycle marks the first inclusion of drugs reimbursed under Medicare Part B, which primarily covers physician-administered treatments, extending beyond the earlier focus on Medicare Part D medications.

The medications chosen address a range of serious health conditions including various forms of cancer, psoriatic arthritis, HIV-1 infection, autoimmune diseases, and severe allergic conditions. CMS has scheduled the negotiation process with pharmaceutical manufacturers for 2026, aiming for any newly negotiated price adjustments to come into force on January 1, 2028.

Alongside these new negotiations, CMS has also selected a previously negotiated drug for a first-time reevaluation under the program.

Program Expansion to Include Medicare Part B Drugs

The latest cycle broadens the scope of the Medicare Drug Price Negotiation Program, evolving beyond prior cycles which exclusively targeted medications covered under Medicare Part D. By incorporating Part B medications—generally those administered by healthcare providers—CMS seeks to apply pricing controls to a larger segment of Medicare drug spending.

CMS emphasized that this evolution is part of ongoing federal efforts, initially launched during the Trump administration, to address the rising costs of prescription drugs impacting seniors and taxpayers.

In the previous cycle, Medicare successfully negotiated prices for all 15 selected drugs, with those pricing agreements set to begin in 2027. CMS estimated that if these negotiated prices had been in effect in 2024, the program would have realized approximately $8.5 billion in net savings on prescription drug expenses, including reductions under the Coverage Gap Discount Program. This figure represents roughly a 36% decrease in net spending on the targeted drugs, underscoring the financial impact of the negotiation initiative.

CMS Leadership Comments

Dr. Mehmet Oz, CMS administrator, stated that excessive prescription drug prices have long burdened seniors and taxpayers alike. He affirmed the agency's objective to focus on the highest-cost drugs within Medicare to negotiate fairer prices, generate savings, and enhance accountability across the program.

Scope and Financial Impact of Selected Drugs

According to CMS, from November 2024 to October 2025, approximately 1.8 million Medicare beneficiaries with either Part D or Part B prescription drug coverage utilized the 15 medications selected for this cycle’s negotiation. Total prescription spending for these drugs reached around $27 billion under Medicare Parts B and D combined, representing roughly 6% of the total expenditures across both parts.

In conjunction with the announcement, CMS released a comprehensive list of 50 drugs eligible for negotiation ranked by their combined Medicare Parts B and D spending. The 15 drugs selected for negotiation during the upcoming cycle represent the highest-spending agents from this list.

Chris Klomp, CMS deputy administrator and director of Medicare, cited the release of the ranking as a demonstration of CMS’s commitment to transparency in the drug pricing negotiation process.

Drugs Selected for the Third Negotiation Cycle

The drugs chosen for negotiation encompass a range of therapies manufactured by leading pharmaceutical companies. The list includes:

  • Anoro Ellipta (umeclidinium bromide/vilanterol) by GSK plc, indicated for chronic obstructive pulmonary disease (COPD)
  • Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) from Gilead Sciences Inc., for HIV infection
  • Botox and Botox Cosmetic by AbbVie Inc.
  • Cimzia (certolizumab pegol) from UCB SA, used to treat autoimmune diseases
  • Cosentyx (secukinumab) by Novartis AG for psoriasis and arthritis
  • Kisqali (ribociclib), also from Novartis AG, for advanced breast cancer
  • Entyvio (vedolizumab) by Takeda Pharmaceutical Company Ltd, prescribed for severe ulcerative colitis or Crohn’s disease
  • Erleada (apalutamide) by Johnson & Johnson, indicated for prostate cancer
  • Lenvima (lenvatinib) from Eisai Co. Ltd., used in thyroid cancer and hepatocellular carcinoma (liver cancer)
  • Orencia (abatacept) by Bristol-Myers Squibb Co., for rheumatoid arthritis
  • Rexulti (brexpiprazole) by Otsuka Holdings Co Ltd, an antipsychotic medication
  • Trulicity (dulaglutide) by Eli Lilly and Co., for type 2 diabetes
  • Verzenio (abemaciclib), also by Eli Lilly and Co., used in breast cancer
  • Xeljanz (tofacitinib) by Pfizer Inc., for inflammatory conditions
  • Xolair (omalizumab), a Genentech unit of Roche Holdings AG and Novartis partnered drug for severe allergic conditions

Drug Selected for Renegotiation

CMS additionally selected Tradjenta (linagliptin), a type 2 diabetes medication produced by Boehringer Ingelheim, for its first renegotiation under the program.


This third cycle of the Medicare Drug Price Negotiation Program highlights CMS's broadening approach to address drug costs more comprehensively by targeting both outpatient prescription drugs under Part D and physician-administered medications under Part B, reflecting a strategic expansion in its cost-containment efforts.

Risks
  • Prices negotiated will not take effect until 2028, so current high drug costs will persist until then.
  • Negotiations depend on drugmakers’ participation and agreement, with outcomes uncertain.
  • The program's expanded scope to Part B drugs may introduce complexities in implementation and cost savings are contingent on successful negotiations.
  • Savings estimates are based on assumptions and prior cycles; actual future savings may vary.
Disclosure
Education only / not financial advice
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