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UPDATES ON MEDICARE PRESCRIPTION DRUG PRICE NEGOTIATIONS
- Michael Braden
- 1 day ago
- 5 min read
Michael T. Braden March 19, 2026 Medicare Part D
MEDICARE IS FINALLY NEGOTIATING DRUG PRICES DIRECTLY WITH THE DRUG MANUFACTURERS
Having been an Independent Medicare Broker for over 10 years, I was always frustrated by the sky-high prices seniors had to pay due to Medicare's Prescription Drug Prices. Finally, the first 10 drugs with their Medicare costs lowered took effect on 1/1/2026. This has been long overdue, and it will be a blessing for far too many Americans who rely on Medicare every day.
But Medicare is not stopping there. Beginning in 2027, we will see Medicare lowering the costs of at least 15 Prescription Medications each year over the next nine years.
I hope this article is a quick read and that you all enjoy the information provided. Our goal every day is to teach and inform others about Medicare and their Medicare choices, and to answer any questions we are asked.
UPDATES ON MEDICARE'S NEXT WAVE OF RE-NEGOTIATED DRUG PRICES
Under the Inflation Reduction Act, Medicare was authorized to negotiate its own Drug Prices. CMS (Medicare) announced it would negotiate new pricing for the 10 Most Popular Prescription Medications each year over the next 5-10 years.
Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2026 NEGOTIATION PROGRAM CENTERS FOR MEDICARE & MEDICAID SERVICES In August 2022, President Biden signed the Inflation Reduction Act of 2022 (P.L. 117-169) into law. The law makes improvements to Medicare by expanding benefits, lowering drug costs, and improving the sustainability of the Medicare program for generations to come. The law provides meaningful financial relief for millions of people with Medicare by improving access to affordable treatments and strengthening Medicare, both now and in the long run. For the first time, the law gives Medicare the authority to negotiate the prices of certain high-expenditure, single-source drugs without direct generic or biosimilar competition. The Centers for Medicare & Medicaid Services (CMS) selected 10 drugs covered under Medicare Part D for the first cycle of negotiations on initial price applicability in 2026. They engaged in voluntary negotiations with the drug companies for those drugs.
Below is the list of negotiated prices, which the statute refers to as Maximum Fair Prices (MFPs), for 10 drugs covered under Medicare Part D that will go into effect beginning January 1, 2026, based on negotiations and agreements reached between CMS and participating drug companies. CMS negotiated in good faith, consistent with the requirements of the law, on behalf of people with Medicare and the Medicare program. Throughout the negotiation process, the CMS team took into account the factors outlined in the law when negotiating these prices, which supports the need for innovation and drug development to achieve better prices for people with Medicare and the Medicare program. CMS engaged in genuine, thoughtful negotiations with each participating drug company. CMS developed an initial offer for each drug, consistent with the process described in the statute and the agency’s guidance, and each manufacturer responded with a counteroffer.
CMS held three meetings with each participating drug company to discuss the offers and counteroffers, review evidence, and seek a mutually acceptable price for the drug. During the negotiation process, CMS revised its offers for each drug upward in response to these discussions. Likewise, many drug companies revised their counteroffers for their drugs downward, based on the discussions with CMS. For five of the selected drugs, this process of exchanging revised offers and counteroffers led CMS and the drug company to agree on a negotiated price during a negotiation meeting. In four of these cases, CMS accepted a revised counteroffer proposed by the drug company. For the remaining five selected drugs, CMS sent a written final offer to those drug companies, consistent with the process described in its guidance, and in each instance, the drug company accepted CMS’s offer on or before the statutory deadline.
Impact of the Negotiated Prices Overall Medicare Spending and Out-of-Pocket Spending in 2023: For the time period between January 1, 2023, and December 31, 2023, about 8.8 million of the 54 million people with Medicare Part D coverage were dispensed these drugs to treat a variety of conditions, such as cardiovascular disease, diabetes, autoimmune diseases, and cancer. These selected drugs accounted for $56.2 billion in total Part D gross covered prescription drug costs during 2023, or about 20% of the total. During that same period, people with Medicare Part D prescription drug coverage incurred $18.9 billion in out-of-pocket costs for all Part D-covered drugs, including $3.9 billion for drugs selected for negotiation.
Estimated Medicare Net Savings in 2023: Compared to 2023 Medicare spending net of all rebates and certain fees and payments, if the prices agreed to between CMS and participating drug companies under the Negotiation Program had been in effect during 2023, the negotiated prices would have saved an estimated $6 billion in net covered prescription drug costs, which would have represented 22% lower net spending in aggregate. Projected Savings for People with Medicare Part D Coverage: When the negotiated prices go into effect in 2026, people enrolled in Medicare prescription drug coverage would save under the projected defined standard benefit design an estimated $1.5 billion.
2026 PRICES AFTER NEW PRICES WERE NEGOTIATED FOR THE 2026 PLAN YEAR
ELIQUIS dropped 56% from $521.00 to $231.00.
JANUVIA dropped 79% from $527.00 to $113.00.
FIASP & NOVOLog Flex Pens dropped 76% from $495.00 to $119.00.
FARXIGA dropped 68% from $556.00 to $178.50.
ENBREL dropped 67% from $7,106.00 to $2,355.00.
JARDIANCE dropped 66% from $573.00 to $1697.00.
STELARA dropped 66% from $$13,836 to $4,695.00
XARELTO dropped 62% from $517.00 to $197.00.
ENTRESTO dropped 53% from $628.00 to $295.00.
IMBRUVICA dropped 38% from $14,934 to $9,319.00.
The prices above went into effect on January 1, 2026.
2026 PRICES AFTER NEW PRICES WERE NEGOTIATED FOR THE 2027 PLAN YEAR
The prices below will go into effect on January 1, 2027:
OZEMPIC/RYBELSUS/WEGOVY is dropping 71% from $959.00 to $274.00.
TRELEGY ELIPTA is dropping 73% from $654 to $175.00.
XTANDI is dropping 48% from $13,480 to $7,004.00.
POMALYST is dropping 60% from $21,744 to $8,650.00.
OFEV is dropping 50% from $12,622 to $6,350.00.
IBRANCE is dropping 50% from $15,741 to $7,871.00.
LINZESS is dropping 75% from $539.00 to $136.00.
CALQUENCE is dropping 40% from $14,228 to $8,600.00.
AUSTEDO/AUSTEDO XR is dropping 38% from $6,623.00 to $4,093.00.
BREO ELIPTA is dropping 83% from $397.00 to $67.00.
XIFAXAN is dropping 63% from $2,696.00 to $1,000.00.
VRAYLAR is dropping $44% from $1,376.00 to $770.00.
TRADJENTA is dropping 84% from $488.00 to $78.00.
JANUMET/JANUMET XR is dropping 85% from $526.00 to $80.00.
OTEZLA is dropping 65% from $4,722.00 to $1,650.00.
2027 PRICES AFTER NEW PRICES WERE NEGOTIATED FOR THE 2028 PLAN YEAR
The Medications listed below will have newly renegotiated pricing that takes effect on January 1, 2028.
TRULICITY.
BIKTARVY.
ORENCIA.
COSENTYX.
ERLEADA.
KISQALI.
$ENTYVIO.
VERZENIO.
BOTOX/BOTOX COSMETIC.
LENVIMA.
XOLAIR.
REXULTI.
XELJANZ/XELJANZXR.
ANORO ELLIPTA.
CIMZIA.
Many of you have asked why we chose the Red, White, and Blue Flag Logo and color palette. The answer is in honor of my father, Tillman Braden Jr. Dad retired as a Chief Master Sergeant and is laid to rest at Arlington National Cemetery in Washington, DC. My father taught me to be polite, sincere, well-informed, never late, and to understand what it means to serve others honorably.
As an Independent Medicare Broker, we are sincerely honored to serve our friends, family, and neighbors in retirement. We genuinely love what we do, we are patient, and we enjoy teaching and explaining things in a way that is easy for others to follow and understand.
In addition to being an Independent Medicare Broker serving clients in 12 states, I am also a Certified Medicare Planner. If I can ever be of service to you or any of your friends or family, please feel free to call me anytime, or text, email me at mike@bradenmedicare.com, or submit a contact request on our website at www.bradenmedicare.com.
