The Inflation Reduction Act (IRA) of 2022 gave Medicare the authority to negotiate prices for some of the most expensive prescription drugs covered by the program. In 2026, people with Medicare Part D will see the first direct results of this reform as negotiated prices have taken effect for 10 high-cost brand-name medications.
These negotiated prices are projected to save $1.5 billion annually in out-of-pocket costs for Medicare beneficiaries and $6 billion per year for the Medicare program overall, with prices discounted by at least 38% from 2023 list prices.
The First 10 Drugs with Negotiated Medicare Prices (2026)
Drugs selected for negotiation must be brand-name medications without competition and among those that drive the highest Medicare spending. The first ten drugs include treatments for serious, chronic, and often life-threatening conditions:
- Eliquis (blood clots)
- Enbrel (rheumatoid arthritis)
- Entresto (heart problems)
- Farxiga (diabetes and kidney disease)
- Imbruvica (cancer)
- Januvia (diabetes)
- Xarelto (blood clots)
- Jardiance (diabetes)
- NovoLog (diabetes)
- Stelara (Crohn’s disease and other autoimmune conditions)
In 2022 alone, Medicare Part D invested nearly 20% of all Part D spending on just these ten drugs (approximately $46.4 billion)—while beneficiaries paid $3.4 billion out of pocket. By targeting drugs with the highest total spending, the program addresses both medications that are extremely expensive per patient and those that are widely prescribed.
What Beneficiaries Need to Know
- All eligible Medicare beneficiaries will have access to negotiated prices
- No action is required — savings are applied automatically through Part D plans
- New drugs will be added to the negotiated list every year
- The 2026 maximum out-of-pocket cap is $2,100
- If drug costs are still a challenge, you may qualify for Extra Help, Medicare’s program to reduce prescription drug costs for those eligible
Medicare is already negotiating prices for 15 additional drugs, with new negotiated prices—including popular medications like Ozempic—scheduled to take effect in 2027. Each round of negotiation is cumulative, meaning negotiated drugs remain on the list while new ones are added in future years.
H.R. 1 Weakens This Progress of Drug Negotiations
Unfortunately, the 2025 budget reconciliation bill (H.R. 1) reduced the effectiveness of the IRA’s drug negotiation program by further limiting which drugs Medicare can negotiate. According to KFF, this change is expected to increase Medicare spending by at least $5 billion, which ultimately puts upward pressure on beneficiary costs.
California Health Advocates joins advocates across the country in strongly oppose efforts to scale back the IRA’s negotiation framework. Medicare should be negotiating prices for more drugs, not fewer, and other cost-saving reforms should be expanded to benefit people across all types of health coverage.
Need Help in Obtaining and/or Understanding Your Coverage?
To compare Part D plans or check which pharmacies you can use, visit medicare.gov/plan-compare.
For free, unbiased assistance with Medicare and prescription drug costs, contact your local Health Insurance Counseling and Advocacy Program (HICAP) in California at 1-800-434-0222. If you are in a different state, you can contact your local State Health Insurance Assistance Program (SHIP) by visiting www.shiphelp.org.
