Medicare's Negotiated Drug Prices Are Live. Here Is What Got Cheaper

Ten prescription drugs got cheaper for Medicare on January 1, 2026, not because a manufacturer cut its list price, but because the federal government negotiated a lower one and made it stick. For the first time, Medicare set a ceiling price, called a maximum fair price, on drugs covered under Part D, and that ceiling took effect this year for medications used by millions of people: blood thinners, diabetes pills, a heart failure drug, and several expensive specialty drugs for arthritis, psoriasis, and blood cancer. A second, larger round of negotiated prices, covering Ozempic, Wegovy, and other drugs, is set to take effect January 1, 2027. Here is what actually changed, what is coming, and how much of it a person picking up a prescription will notice.

What got cheaper on January 1

The 10 drugs are Eliquis, Enbrel, Entresto, Farxiga, Imbruvica, Januvia, Jardiance, NovoLog and Fiasp, Stelara, and Xarelto. CMS announced the negotiated maximum fair prices for this group on August 15, 2024, and the prices became binding on January 1, 2026, according to the agency's fact sheet on negotiated prices for initial price applicability year 2026. A maximum fair price is the most a manufacturer can be paid for that drug under Part D, not a suggestion, and every plan and pharmacy has to honor it. That same CMS fact sheet compares 2023 list prices to the 2026 negotiated prices for a 30-day supply. Three examples show the range:

• Eliquis, a blood thinner: $521 down to $231, a 56 percent cut.
• Januvia, for type 2 diabetes: $527 down to $113, a 79 percent cut.
• Enbrel, for rheumatoid arthritis: $7,106 down to $2,355, a 67 percent cut.

Those are list prices, the sticker amount before rebates, not what Medicare was actually paying before negotiation. Even so, CMS estimated that if the 10 negotiated prices had applied in 2023, net spending on those drugs would have been about 22 percent lower, saving an estimated $6 billion, according to that same August 2024 fact sheet. CMS also projected, in the same document, that people enrolled in Part D would save about $1.5 billion in out-of-pocket costs in 2026 because of the lower prices.

Round two: semaglutide and 14 other drugs, priced for 2027

CMS and HHS selected 15 more Part D drugs for negotiation on January 17, 2025, including the three semaglutide products Ozempic, Rybelsus, and Wegovy, all made by Novo Nordisk, along with drugs for cancer, lung and breathing conditions, diabetes, and psoriasis. CMS guidance published on October 2, 2024, set a deadline of November 30, 2025, for publishing negotiated prices for the group, with prices effective January 1, 2027. CMS published the results ahead of that deadline, in late November 2025. NPR reported the new prices on November 26, 2025, and CMS's own fact sheet on negotiated prices for initial price applicability year 2027 lists every figure.

For semaglutide, the negotiated price is $274 for a 30-day supply, down from a 2024 list price of $959, a 71 percent reduction, per that CMS fact sheet. The same price applies across the three brands built on the molecule: Ozempic and Rybelsus for diabetes, and Wegovy for obesity and cardiovascular risk.

The other 14 drugs in this round show how uneven the cuts are. Janumet, a diabetes pill, drops 85 percent, from $526 to $80. Austedo, prescribed for Huntington's disease and tardive dyskinesia, drops only 38 percent, from $6,623 to $4,093. Across all 15 drugs, CMS estimated the negotiated prices would have cut net drug spending by 44 percent, or about $12 billion, had they applied in 2024. KFF's Key Facts page on the negotiation program, updated March 11, 2026, cites that same $12 billion figure and adds that Part D enrollees would have saved roughly $685 million out of pocket that year.

What actually changes at the pharmacy counter

None of this automatically changes plan premiums or how a formulary is built. What it can change is the cost-sharing math inside Part D's redesigned benefit. Under the standard 2026 design, a person pays 100 percent of drug costs up to a $615 deductible, then 25 percent coinsurance until total out-of-pocket spending hits $2,100, according to CMS's Final CY 2026 Part D Redesign Program Instructions, published April 7, 2025. That $2,100 figure is the 2026, inflation-adjusted version of the $2,000 annual cap the Inflation Reduction Act set for 2025. Past that point, an enrollee owes nothing more for covered drugs for the rest of the year.

That structure is exactly why a negotiated price matters most to someone still in the deductible or coinsurance phase. A pharmacy calculates what a patient owes off the negotiated maximum fair price, not the old list price, according to an October 16, 2025, research brief from the University of Southern California's Schaeffer Center on how these prices reach patients. Someone paying 25 percent coinsurance on Eliquis now pays 25 percent of $231, not 25 percent of $521. Someone who already passed the $2,100 cap earlier in the year owes nothing for that drug either way. The negotiation lowers what Medicare and the plan pay. That patient's bill was already zero.

There is a separate tool for people who would rather not pay a large amount at once while still in the deductible or coinsurance phase. The Medicare Prescription Payment Plan, which CMS also calls smoothing, lets Part D enrollees split their out-of-pocket drug costs into capped monthly installments spread across the calendar year instead of paying it all at the pharmacy counter. It does not lower the total amount owed. It only spreads the same total into smaller, more predictable payments, according to CMS's Medicare Prescription Payment Plan page, updated March 24, 2026.

Where to keep expectations in check

Premiums move on a different track than negotiated prices. CMS projected in a September 26, 2025, press release that the average standalone Part D premium would fall to about $34.50 in 2026, down from $38.31 in 2025, and credited tighter oversight of plan bids, not drug negotiation, for that drop. Whether a person feels the negotiated price at all still depends on plan design. The Medicare Rights Center noted on October 9, 2025, that savings reach an individual only if their plan's cost-sharing is tied to the drug's price, through coinsurance or the deductible, rather than a flat copay the plan sets on its own. What the law does guarantee is access: every Part D plan must cover a selected drug, in every dosage and form, once its negotiated price takes effect, according to a KFF explainer published September 26, 2023. Between the two rounds, that rule now covers 25 drugs, 10 already in effect and 15 more arriving in 2027.

This is general information, not medical or insurance advice. CMS.gov and your own plan's formulary are the authoritative sources. Questions go through our contact page.