Medicare's first negotiated drug prices cut 10 drugs 38% to 79%, from 2026

Medicare's first-ever negotiated drug prices cover exactly 10 drugs, and the discounts off their 2023 list prices range from 38% to 79% [s1]. The prices take effect on 1 January 2026, apply only within Medicare, and reach only these 10 named products — so whether you see any change depends entirely on whether you have Medicare Part D and take one of them.

The 10 drugs and the actual numbers

The Centers for Medicare & Medicaid Services announced the negotiated prices — which the law calls Maximum Fair Prices — in August 2024, after a first cycle of negotiation with each manufacturer [s1]. For a 30-day supply, the negotiated 2026 price against the 2023 list price runs like this: the diabetes drug Januvia falls from $527 to $113, a 79% cut; the insulins NovoLog and Fiasp from $495 to $119, a 76% cut; Farxiga from $556 to $178.50, 68%; the arthritis biologic Enbrel from $7,106 to $2,355, 67%; Jardiance from $573 to $197, 66%; the immune-disease biologic Stelara from $13,836 to $4,695, 66%; the blood thinner Xarelto from $517 to $197, 62%; the blood thinner Eliquis from $521 to $231, 56%; the heart-failure drug Entresto from $628 to $295, 53%; and the blood-cancer drug Imbruvica from $14,934 to $9,319, a 38% cut [s1].

These 10 were not chosen at random. The Inflation Reduction Act directs CMS to select from the drugs with the highest total Medicare Part D spending that have been on the market for years without generic or biosimilar competition [s2]. Eliquis alone accounted for $18.3 billion in Part D gross covered drug costs in 2023 and was used by 3.9 million enrollees [s1].

Who actually pays less, and who does not

This is the part the discount headlines obscure. The negotiated price is what Medicare and its drug plans pay; it is not automatically what shows up as a patient's copay. What an individual on Medicare pays out of pocket still depends on their plan's benefit design.

For the whole population, CMS estimated that if the negotiated prices had been in effect in 2023, they would have saved about $6 billion in net costs across the 10 drugs — roughly 22% lower net spending — and that when the prices take effect in 2026, people enrolled in Medicare drug coverage would save an estimated $1.5 billion [s1]. Note the word "net": that $6 billion is measured against 2023 spending after existing rebates, not against list prices, which is why it is far smaller than the 38-to-79% headline cuts imply. A large discount off an inflated list price is not the same as a large cut to what the program was already paying after rebates.

Crucially, none of this touches commercial insurance. If you get coverage through an employer or the ACA marketplace rather than Medicare, the negotiated prices do not apply to you. About 8.8 million of the 54 million people with Medicare Part D were dispensed one of these 10 drugs in 2023 [s1] — a large number, but a fraction of everyone taking them.

Why "up to 20 a year" arrives slowly

The program expands, but on a deliberate schedule. A second cycle covering 15 more Part D drugs is set to take effect in 2027, and later cycles bring in drugs covered under Part B — the ones administered in clinics — with the program eventually able to negotiate up to 20 drugs a year [s2]. Because a drug must have been on the market for a set number of years before it is even eligible, the newest and often most expensive launches are structurally out of reach for a long time.

What the evidence does and does not show yet

The 2026 prices are real and specific, but their downstream effects are not yet measured. Whether negotiation meaningfully lowers what individual patients pay at the pharmacy counter, whether drug plans respond by shifting formularies, and whether manufacturers raise launch prices on newer drugs to compensate are all open empirical questions that will only be answerable once the prices have been in effect. The industry challenged the program in court; the prices announced here proceeded on schedule.

For now, the honest summary is precise. Ten drugs, discounts of 38% to 79% off 2023 list prices, effective January 2026, inside Medicare only, saving the program an estimated $6 billion measured against post-rebate 2023 spending. Everything beyond those figures — the effect on your specific copay, on commercial prices, on future launches — is not settled by the announcement, only set in motion by it.