Medicare Drug List Prices and Prescription Drug Spending

Leigh Purvis, AARP Public Policy Institute

Published January 22, 2026

Senior African American woman paying bills

List prices for 25 top Medicare drugs that are not currently selected for Medicare drug price negotiation have increased by an average of 67 percent since they first entered the market. Medicare covers prescription drugs through Part B, which pays for drugs administered by health care providers, and Part D, which pays for self-administered drugs. On average, one third of current list prices for these drugs is due to price increases that occurred after the products entered the market. Together, these 25 drugs accounted for nearly $50 billion in Medicare prescription drug spending in 2023 and were used by more than 11 million Medicare beneficiaries. Read the full report.

Key Takeaways:

List prices for 25 top Medicare drugs not currently selected for Medicare drug price negotiation have increased by an average of 67 percent since they first entered the market.
Overall, these top 25 drugs were responsible for nearly $50 billion in total Medicare prescription drug spending in 2023 and were used by a total of more than 11 million Medicare beneficiaries.
Twenty of the 25 drugs had lifetime price increases that exceeded the corresponding rate of general inflation.
On average, 33 percent of each drug’s current list price is attributable to price increases that occurred after market entry.
Each of the 25 drugs generated $900 million or more in total Medicare spending in 2023, yet many are unlikely to be selected for Medicare drug price negotiation in 2026 due to a variety of exemptions.

The summary on this page, and information that helps optimize its search retrieval, were created with the assistance of Microsoft Copilot, and have been reviewed for accuracy and appropriateness.

Purvis, Leigh. Prices for Top Medicare Drugs Have Increased Substantially Since Entering the Market. Washington, DC: AARP Public Policy Institute, January 22, 2026. https://doi.org/10.26419/ppi.00394.001

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Full Report