CMS Selects 15 Drugs for Third Cycle of Medicare Drug Price Negotiation Program

The US Centers for Medicare & Medicaid Services (CMS) has announced the selection of 15 high-cost prescription drugs covered under Medicare Part D and, for the first time, drugs payable under Medicare Part B for the third cycle of the Medicare Drug Price Negotiation Program. CMS additionally selected 1 previously negotiated drug, linagliptin (Tradjenta), for the program’s first renegotiations.

Under this program, CMS directly negotiates the prices of certain high expenditure, single source drugs without generic or biosimilar competition. As described in a January 27, 2026, release, negotiations with participating drug companies will occur in 2026 and any negotiated and renegotiated prices will become effective January 1, 2028.

“For too long, seniors and taxpayers have paid the price for skyrocketing prescription drug costs,” CMS Administrator Mehmet Oz, MD, MBA, said in a statement. “Under President Trump’s leadership, CMS is taking strong action to target the most expensive drugs in Medicare, negotiate fair prices, and make sure the system works for patients—not special interests. This approach delivers real savings while strengthening accountability across the program.”

CMS selected 10 and 15 drugs covered under Medicare Part D for the first and second cycle of negotiations, respectively, that now have negotiated prices, which the statute refers to as maximum fair prices. These prices are effective beginning January 1, 2026 for the first cycle and January 1, 2027 for the second cycle, based on negotiations and agreements reached between CMS and participating drug companies.

CMS announced the selection of the below list of 15 drugs payable under Medicare Part B and/or covered under Medicare Part D for the third cycle of negotiations, with an initial price applicability year 2028:

• Umeclidinium/vilanterol (Anoro Ellipta)
• Bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy)
• Botulinum toxin (Botox; Botox Cosmetic)
• Certolizumab pegol (Cimzia)
• Secukinumab (Cosentyx)
• Vedolizumab (Entyvio)
• Apalutamide (Erleada)
• Ribociclib (Kisqali)
• Lenvatinib (Lenvima)
• Abatacept (Orencia)
• Brexpiprazole (Rexulti)
• Dulaglutide (Trulicity)
• Abemaciclib (Verzenio)
• Tofacitinib (Xeljanz; Xeljanz XR)
• Omalizumab (Xolair)

In the second cycle of negotiations, Medicare reached agreement with participating manufacturers on all 15 selected drugs, with those prices set to take effect on January 1, 2027. Had those new prices been in effect in 2024, they would have saved an estimated $8.5 billion in net covered prescription drug costs (inclusive of Coverage Gap Discount Program Spending), which would have amounted to approximately 36% reduced net spending in aggregate.

Between November 2024 and October 2025, approximately 1.8 million people with Medicare Part D or Medicare Part B coverage used the 15 drugs selected for initial negotiation to treat a variety of conditions, including cancer, psoriatic arthritis, and human immunodeficiency virus type 1 infection. These drugs accounted for approximately $27 billion in total prescription drug spending under Medicare Part B and Part D, representing about 6% of total Part B and Part D spending.

CMS is also releasing a list of 50 top negotiation-eligible drugs based on combined expenditures under Medicare Parts B and D. The drugs selected for the third cycle represent the top 15 highest-spending drugs on this list.

“The publication of the list of top 50 negotiation-eligible drugs evidences CMS’ commitment to transparency,” said CMS Deputy Administrator and Director of Medicare Chris Klomp. “By applying clear eligibility criteria and practical negotiation policies, we are ensuring the program responds to market changes while delivering fairness and value for the American people.”

As described in the release, all drugs were selected in accordance with the final guidance for the third cycle of negotiations, which incorporated refinements based on public feedback to increase the transparency of the Negotiation Program.

Drug companies with a selected drug for the third cycle of negotiations will have until February 28, 2026, to decide if they will participate in negotiations, during which CMS will consider the selected drug’s clinical benefit, evidence about alternative treatments, the extent to which it addresses unmet medical needs, and its impact on specific populations, including people who rely on Medicare. Of note, CMS also considers other information, such as costs associated with research and development as well as current costs of production and distribution for selected drugs.

References

1. Centers for Medicare & Medicaid Services. CMS Announces Selection of Drugs for Third Cycle of Medicare Drug Price Negotiation Program, Including First-Ever Part B Drugs. January 27, 2026. Accessed January 29, 2026. https://www.cms.gov/newsroom/press-releases/cms-announces-selection-drugs-third-cycle-medicare-drug-price-negotiation-program-including-first

2. Centers for Medicare & Medicaid Services. Medicare Drug Price Negotiation Program: Selected Drugs for Initial Price Applicability Year 2028. https://www.cms.gov/files/document/factsheet-medicare-negotiation-selected-drug-list-ipay-2028.pdf