What Happened
For the first time, Medicare negotiated directly with pharmaceutical companies on the price of 10 high-cost drugs. The negotiated prices took effect January 1, 2026. They apply to Medicare Part D (prescription drug plans) and Medicare Advantage drug coverage.
The biggest reductions: Eliquis (blood thinner) — 56% lower. Jardiance (diabetes/heart failure) — 66% lower. Xarelto (blood thinner) — 62% lower. Farxiga (diabetes) — 68% lower.
The 10 Negotiated Drugs
| Drug | Used for | Price reduction |
|---|---|---|
| Eliquis | Blood clots, AFib | 56% |
| Jardiance | Diabetes, heart failure | 66% |
| Xarelto | Blood clots, AFib | 62% |
| Januvia | Diabetes | 79% |
| Farxiga | Diabetes, kidney disease | 68% |
| Entresto | Heart failure | 53% |
| Enbrel | Rheumatoid arthritis | 67% |
| Imbruvica | Blood cancer | 38% |
| Fiasp/NovoLog | Diabetes (insulin) | 76% |
| Stelara | Psoriasis, Crohn's | 66% |
How to Get the Lower Price
- Your copay depends on your specific Part D plan: The negotiated price reduces what your plan pays; your copay is set by your plan's formulary tier. Plans must pass the savings through, but the amount varies.
- Check your plan's updated formulary: Log in to your Part D plan's website or call the number on your card and ask specifically about your drug's cost-sharing in 2026.
- If you're on Original Medicare: The negotiated prices apply when you fill the prescription at a pharmacy in-network with your Part D plan.
- Extra Help program: Low-income Medicare beneficiaries may have $0 or $1–$3 copays even before negotiation. Apply at ssa.gov.
The Policy Debate
- Medicare is the largest drug buyer in the world — it should use that leverage the way the VA and every other large buyer does.
- Americans pay 2–4x what patients in other developed countries pay for identical drugs; negotiation closes part of that gap.
- Lower prices reduce Medicare spending and extend the life of the Medicare trust fund.
- Lower prices reduce the return on R&D investment, which may reduce incentives to develop new drugs — particularly for rare diseases with small patient populations.
- The 10 drugs selected for the first negotiation cycle are high-revenue blockbusters, but future rounds could extend to drugs with smaller margins and more fragile development economics.
What to Watch
- Round 2 (2027): CMS will negotiate prices on 15 additional drugs. The list will be announced in 2026.
- Legal challenges: Several pharmaceutical companies sued to block negotiation; courts have largely ruled in CMS's favor, but litigation continues.
- Congressional action: Proposals to roll back negotiation authority are circulating in the 2026 Congress. Track at congress.gov.