Enrollees Taking the First Medicare-Negotiated Prescription Drugs Will Have Lower Out-of-Pocket Costs in 2026

Lower out of pocket costs are coming for millions of people when the first Medicare-negotiated drug prices take effect on January 1, 2026. The 10 negotiated drugs are used by nearly 9 million Part D enrollees to treat conditions including heart disease, diabetes, autoimmune diseases, and cancer. According to the Centers for Medicare and Medicaid Services, the first Medicare-negotiated prices are substantially lower than what private Part D prescription drug plans were negotiating and could save enrollees a collective $1.5 billion in out-of-pocket expenses in 2026.  Read the full report. 

Key Takeaways: 

• The first 10 Medicare-negotiated drug prices will become available on January 1, 2026, and additional drugs will be selected and negotiated every year going forward. 
• Part D plan enrollee cost-sharing for these 10 drugs will decrease by an average of approximately 50 percent among stand-alone Part D plans that were available in five states with high Medicare enrollment. 
• Medicare drug price negotiation is currently working as anticipated and will reduce enrollees’ out-of-pocket costs in 2026, likely due to the prevalence of cost-sharing that is directly linked to drug prices. 
• Ongoing efforts to exempt more drugs from Medicare drug price negotiation will negatively affect Part D enrollees by effectively eliminating the possibility of lower cost-sharing that could help improve enrollee access to those products. 

The 10 medications included in the first round of Medicare drug price negotiation are: 

1.  Eliquis for blood clot prevention & treatment 
2.  Enbrel for rheumatoid arthritis, psoriasis & psoriatic arthritis 
3.  Entresto for heart failure 
4.  Farxiga for diabetes, heart failure & chronic kidney disease 
5.  Fiasp and NovoLog, types of insulin for diabetes 
6.  Imbruvica for blood cancers 
7.  Januvia for diabetes 
8.  Jardiance for diabetes, heart failure & chronic kidney disease 
9.  Stelara for psoriasis, psoriatic arthritis, Crohn’s disease & ulcerative colitis 
10.  Xarelto for blood clot prevention & treatment