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2026 Is First Year Medicare Beneficiaries Will Get Discounts on 10 High-Cost Drugs

A second set of 15 medications are on the bargaining table now. Those lower prices will debut in 2027


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AARP (Getty Images)

Key takeaways

After years of preparation, the first 10 Medicare Part D–covered drugs selected for price negotiations will be available to beneficiaries at reduced cost in 2026.

A prescription drug law passed in 2022, which AARP supported, required the Secretary of the Department of Health and Human Services to negotiate with drug companies for lower prices on 10 popular brand-name, high-priced drugs with no generic equivalent or biosimilar competitors.

The program is on the cusp of making dozens of innovative medications more affordable and accessible while saving lives and improving the quality of life for millions of Medicare beneficiaries. The savings, which take effect Jan. 1, are expected to lower enrollees’ out-of-pocket spending by an estimated $1.5 billion in 2026, according to the Centers for Medicare & Medicaid Services (CMS).

First-round discounts start Jan. 1

The 10 popular medications in the first round of price reductions:

  • Eliquis for blood clot prevention and treatment
  • Enbrel for rheumatoid arthritis, psoriasis and psoriatic arthritis
  • Entresto for heart failure
  • Farxiga for diabetes, heart failure and chronic kidney disease
  • Fiasp and NovoLog, types of insulin for diabetes
  • Imbruvica for blood cancers
  • Januvia for diabetes
  • Jardiance for diabetes, heart failure and chronic kidney disease
  • Stelara for psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis
  • Xarelto for blood clot prevention and treatment

If the lower drug prices had been in effect in 2023, Medicare would have saved an estimated $6 billion, or about 22 percent, on the 10 drugs. That includes rebates and other payments, CMS previously reported.

For instance, a 30-day supply of the diabetes medication Januvia will cost $113 in 2026. That’s down 79 percent from the 2023 list price of $527, CMS says. Medicare’s Part D program spent more than $4 billion on Januvia for the roughly 850,000 beneficiaries who used it in 2023.

All but 4 percent of respondents said the government should do more to lower prescription prices, according to a December 2024 AARP survey of more than 1,000 adults 50 and older. More than 4 out of 5 said they take prescriptions regularly.

A 30-day supply of Eliquis, which treats and prevents blood clots, will be 56 percent lower next year, or $231 compared with $521 in 2023, CMS reports. Medicare spent nearly $18.3 billion on Eliquis for the nearly 4 million beneficiaries who used the drug in 2023.

Price decrease will last beyond 2026

The lower negotiated prices must be made available to eligible beneficiaries, and the 10 medications must be included among the prescriptions for all Medicare Advantage plans with drug coverage and stand-alone Part D plans for people in original Medicare.

The negotiated price will apply to a selected prescription as long as it remains in the program. Each subsequent year a drug is in the program, CMS will publish an updated price.

Talks with drug manufacturers on a second round of 15 medications have been taking place throughout 2025, and new, lower prices will take effect in 2027. The 15 drugs account for about $41 billion in Part D spending, and roughly 5.3 million beneficiaries use them to treat conditions such as asthma, cancer and diabetes.

Bargaining for an additional combination of drugs covered under Part B, generally given intravenously or in doctors’ offices and outpatient centers, and Part D will be announced next year. Those discounts will take effect in 2028.

In 2027 and later, the number of Part B and Part D drugs being negotiated will increase to 20. Those lower prices will be effective in 2029, and the number of discounted medications will continue to accumulate over time.

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