Medicare Drug Price Negotiations: Is Your Prescription on the 2026 List?

Big changes are coming to Medicare, and they could mean significant savings on your prescription drugs. Thanks to new legislation, Medicare is now able to negotiate prices for some of the most common and costly medications. If you’re wondering whether your prescriptions will be cheaper, you’ve come to the right place for a clear, straightforward answer.

Understanding the New Medicare Drug Discounts

For the first time, the Centers for Medicare & Medicaid Services (CMS) has the authority to negotiate prescription drug prices directly with pharmaceutical companies. This change is part of the Inflation Reduction Act of 2022, a law designed to lower healthcare costs for millions of Americans.

The process is starting with a select group of 10 drugs that are widely used by people on Medicare and account for a significant portion of spending. The newly negotiated, lower prices for these specific medications will go into effect on January 1, 2026. This is just the beginning, as more drugs will be selected for negotiation in the coming years.

The First 10 Drugs Selected for Price Negotiation

This is the list everyone is waiting for. The first step in checking if your costs will go down is to see if your medication is on this initial list. Below are the 10 drugs chosen by CMS for the first round of price negotiations. For each one, we’ve included its common use to help you identify it.

1. Eliquis (apixaban)

  • What it treats: Used to prevent blood clots, reducing the risk of stroke in people with atrial fibrillation.
  • Manufacturer: Bristol Myers Squibb / Pfizer

2. Jardiance (empagliflozin)

  • What it treats: A medication for type 2 diabetes that also helps reduce the risk of cardiovascular death in adults with heart disease.
  • Manufacturer: Boehringer Ingelheim / Eli Lilly

3. Xarelto (rivaroxaban)

  • What it treats: Similar to Eliquis, it’s used to prevent and treat blood clots and reduce the risk of stroke.
  • Manufacturer: Johnson & Johnson

4. Januvia (sitagliptin)

  • What it treats: Used to help control blood sugar levels in adults with type 2 diabetes.
  • Manufacturer: Merck

5. Farxiga (dapagliflozin)

  • What it treats: Used for type 2 diabetes, heart failure, and chronic kidney disease.
  • Manufacturer: AstraZeneca

6. Entresto (sacubitril/valsartan)

  • What it treats: A combination medicine used to treat certain types of heart failure.
  • Manufacturer: Novartis

7. Enbrel (etanercept)

  • What it treats: An injectable biologic drug used to treat several autoimmune conditions, including rheumatoid arthritis and psoriasis.
  • Manufacturer: Amgen

8. Imbruvica (ibrutinib)

  • What it treats: A targeted therapy used to treat certain types of blood cancers, like mantle cell lymphoma and chronic lymphocytic leukemia.
  • Manufacturer: AbbVie / Johnson & Johnson

9. Stelara (ustekinumab)

  • What it treats: A biologic medication used for treating psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.
  • Manufacturer: Johnson & Johnson

10. Fiasp; Fiasp FlexTouch; Fiasp PenFill; Novolog; Novolog FlexPen; Novolog PenFill (insulin aspart)

  • What it treats: These are different brand names for fast-acting insulin products used to manage blood sugar in people with type 1 and type 2 diabetes.
  • Manufacturer: Novo Nordisk

How to Check if Your Medication is Included

The ad you clicked promised to show you how to check if your meds are on the discount list. Here is a simple, step-by-step guide to do just that.

  • Step 1: Compare Your Prescription to the List Above. The most direct way is to look at the list of 10 drugs. Check the name on your prescription bottle or packaging and see if it matches any of the brand names or generic names listed.

  • Step 2: Talk to Your Pharmacist. Your pharmacist is an excellent resource. Take your prescription bottle or a list of your medications to them and ask, “Is the drug I’m taking one of the 10 selected for Medicare price negotiation?” They can confirm the exact drug name and its status.

  • Step 3: Consult Your Doctor. During your next appointment, discuss your medications with your doctor. They can not only confirm if your drug is on the list but also discuss your overall treatment plan. This is especially important if a similar, but not identical, medication is on the list.

  • Step 4: Stay Informed About Future Additions. This is only the first round. Medicare will add more drugs to the negotiation list in the future. An additional 15 drugs will be selected for 2027, another 15 for 2028, and 20 more each year after that. You can check for official updates directly on the Medicare.gov website.

What if My Drug Isn't on This List?

Even if your specific prescription isn’t one of the first 10, there are other major cost-saving changes from the Inflation Reduction Act that may still help you.

  • $2,000 Out-of-Pocket Cap (Starts in 2025): This is a huge change. Starting in 2025, no one on a Medicare Part D plan will have to pay more than $2,000 per year out-of-pocket for their prescription drugs. This cap provides a critical safety net for people with very high drug costs.

  • $35 Monthly Cap on Insulin: If you use insulin, your monthly cost for each covered insulin product is already capped at $35. This benefit is in effect now for people with Medicare Part D.

  • Free Recommended Vaccines: All adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP), such as the shingles vaccine, are now available at no cost to you if you have Part D coverage.

These provisions are designed to make healthcare more affordable for everyone on Medicare, not just those taking one of the 10 drugs on the initial negotiation list.

Frequently Asked Questions

When do the lower prices for these 10 drugs actually start? The new, negotiated prices for the first 10 drugs will take effect on January 1, 2026. The negotiation process between Medicare and the drug manufacturers is currently underway.

How much money will I actually save? The exact savings for each drug are not yet known. The final negotiated prices are expected to be published by September 1, 2024. However, the goal of the program is to create substantial savings for both beneficiaries and the Medicare program.

Will this negotiation process affect my Medicare Advantage or Part D plan? Yes. These negotiated prices will apply to drugs covered under Medicare Part D. If you get your drug coverage through a standalone Part D plan or as part of a Medicare Advantage plan, you will benefit from these lower prices once they are in effect.