Medicare Just Cut Drug Prices by Up to 79%. Nine Million Americans Are Eligible for the Savings. Most Don’t Know They Qualify.

WASHINGTON, April 29, 2026 —

Key Takeaways

• For the first time in Medicare’s 60-year history, the federal government directly negotiated prescription drug prices with pharmaceutical companies — and the first 10 negotiated prices took effect January 1, 2026, reducing costs for drugs that in 2022 alone accounted for $46.4 billion in Medicare Part D spending.
• The price reductions range from 38% to 79% off the 2023 list price, with AARP projecting that Part D enrollees will see average out-of-pocket costs fall by more than 50% for the negotiated drugs — and that 7 of the 10 drugs will cost less than $100 per month for most enrollees.
• The savings are on top of the new $2,100 hard cap on annual Part D out-of-pocket spending that also took effect January 1, 2026 — meaning the combination of negotiated prices and the spending cap represents the most significant reduction in Medicare drug costs in a generation.

Why These 10 Drugs Were Chosen — and Why They Matter

Medicare drug price negotiation did not start with cheap generics or obscure specialty medications. It started with the drugs that cost the most and are used by the most people. The 10 medications selected for the first cycle of negotiation are among the most prescribed in the country — treatments for conditions that affect tens of millions of older Americans and that patients typically take every day for the rest of their lives.

The selection criteria required that the drugs have no generic or biosimilar competition — meaning pharmaceutical companies faced no market pressure to lower prices — and that they be among the highest-spending drugs in Medicare. In 2022, these 10 drugs alone accounted for 19% of all Medicare Part D spending. Nine million Medicare beneficiaries relied on at least one of them.

The negotiated prices — formally called Maximum Fair Prices — represent what CMS describes as the lowest price any Medicare beneficiary should pay for these drugs under any Part D plan. No plan can charge more than the Maximum Fair Price for a selected drug. Some plans may charge less.

The 10 Drugs — What They Treat and How Much Cheaper They Are

The breadth of these conditions — heart disease, diabetes, blood clots, autoimmune disorders, blood cancer — means the negotiated prices touch virtually every category of serious chronic illness that older Americans manage daily. For a Medicare beneficiary taking Eliquis for atrial fibrillation and Jardiance for diabetes simultaneously, the combined savings from negotiated prices could easily exceed $2,000 a year in out-of-pocket costs.

The Problem Nobody Is Talking About — Beneficiaries Still Paying Old Prices

Here is the gap between the policy announcement and the reality at pharmacy counters across the country: the Maximum Fair Price is available — but it is not automatically applied in every transaction, and many beneficiaries have no idea it exists.

Medicare beneficiaries enrolling in new Part D plans were automatically moved into plans that reflect the negotiated prices for 2026. But some long-term enrollees in existing plans — particularly those who have not reviewed their plan’s 2026 formulary — may still be paying cost-sharing amounts based on pricing structures that have not been updated at their preferred pharmacy. One commenter on the Medicare Rights Center’s public forum described exactly this situation: “I take Eliquis. While the price on it for 2026 is ‘lowered,’ my Medicare Part D supplier for 2026 raised the price by 20%. So, what is the point of lower prices that really don’t exist?”

The answer involves a distinction between the Maximum Fair Price — which is the negotiated price the drug company must make available — and the cost-sharing amount a beneficiary actually pays at the pharmacy, which is determined by their specific plan’s benefit design. The two numbers are related but not identical. Beneficiaries need to verify their plan’s actual cost-sharing for each negotiated drug — not assume the savings are flowing through automatically.

The $2,100 Cap That Amplifies Everything

The negotiated prices do not operate in isolation. They work alongside the new $2,100 hard cap on annual out-of-pocket Part D drug spending that also took effect January 1, 2026 — the first such absolute ceiling in Medicare’s history.

The interaction between these two provisions is significant. Before the $2,100 cap, a beneficiary taking Enbrel for rheumatoid arthritis could face out-of-pocket drug costs that ran to $5,000 or $6,000 a year in the catastrophic spending phase. Under the new structure, negotiated prices lower the base cost, and the $2,100 cap limits total annual exposure regardless of what happens. For the roughly 3.6 million Medicare beneficiaries who previously hit catastrophic spending levels, the combination of these two provisions represents a structural elimination of the worst-case scenario in prescription drug costs.

More Drugs Are Coming — 15 in 2027, 15 More in 2028

The ten drugs that took effect January 1, 2026 are the first cycle of what Congress designed as an expanding program. Fifteen drugs selected in the second cycle will see their negotiated prices take effect January 1, 2027 — including blockbuster treatments for diabetes, HIV, asthma, arthritis, psoriasis, and Crohn’s disease. A third cycle of 15 drugs is being negotiated now, with prices taking effect in 2028.

The Congressional Budget Office projects the full negotiation program will save Medicare $98.5 billion over the coming decade. Each additional cycle of negotiation adds to that total cumulatively — prices negotiated in earlier rounds remain in effect while new rounds bring additional drugs under the framework.

One significant complication: the One Big Beautiful Bill Act, signed in July 2025, narrowed the categories of drugs eligible for negotiation by broadening the orphan drug exclusion. KFF estimates this change will increase Medicare spending by at least $5 billion relative to what the original IRA framework would have delivered — meaning the savings, while still substantial, are smaller than they would have been under the original law.

Pro Tips a Generic Article Would Miss

1. Call your pharmacy directly and ask what your plan pays for your specific drug under the 2026 Maximum Fair Price — not the retail price, not last year’s copay. The Maximum Fair Price is the legally required ceiling. If your pharmacy is charging more than that amount for cost-sharing, the plan may be non-compliant or you may be in the wrong coverage phase. A five-minute phone call to your Part D plan’s member services line can identify whether you are capturing the negotiated savings.

2. If you take Enbrel, Stelara, or Imbruvica, request a formal cost comparison between your 2025 out-of-pocket spending and your 2026 plan’s projected cost — these are the three drugs with the largest absolute dollar reductions. These biologics and specialty drugs were previously among the most expensive medications in Medicare. The retirement income planning implications of a drug that cost $8,000 a year now costing $2,000 or less are substantial — the savings should be factored into your annual healthcare budget.

3. The $2,100 out-of-pocket cap resets every January 1 — plan your tax-advantaged savings withdrawals accordingly. If you know your annual drug costs will not exceed $2,100 under the new cap, you can right-size your healthcare spending reserve and redirect excess Health Savings Account or flexible spending account funds more efficiently. Many retirees are maintaining larger healthcare reserves than the 2026 cost structure actually requires.

The fastest action any Medicare Part D enrollee can take today is to look up their 2026 Evidence of Coverage document, find the formulary section for each drug they take, and compare the listed cost-sharing amount against the Maximum Fair Price published on the CMS website for the 10 negotiated drugs. If you take any of the 10 drugs — Eliquis, Jardiance, Xarelto, Farxiga, Entresto, Enbrel, Imbruvica, Januvia, NovoLog, or Stelara — you are entitled to the negotiated price. Whether you are actually receiving it is a question worth verifying before your next prescription fill.

Frequently Asked Questions

Q: Which 10 drugs did Medicare negotiate lower prices for in 2026? A: The 10 drugs are Eliquis, Jardiance, Xarelto, Farxiga, Entresto, Enbrel, Imbruvica, Januvia, Fiasp/NovoLog insulin aspart, and Stelara. All are covered under Medicare Part D and treat conditions including heart disease, diabetes, blood clots, autoimmune disorders, and blood cancer.

Q: How much cheaper are Medicare’s negotiated drug prices in 2026? A: CMS negotiated reductions of 38% to 79% off 2023 list prices. AARP projects average out-of-pocket costs for Part D enrollees will fall by more than 50% for the negotiated drugs, with 7 of the 10 costing less than $100 per month for most beneficiaries.

Q: How do I access Medicare’s negotiated drug prices? A: The negotiated prices — Maximum Fair Prices — are automatically available through any Medicare Part D plan. Call your plan’s member services line and ask what your cost-sharing will be for your specific drug under the 2026 formulary. Compare that to the Maximum Fair Price published by CMS for the 10 negotiated drugs.

Q: Will more drugs get Medicare-negotiated prices after 2026? A: Yes. Fifteen additional drugs will see negotiated prices take effect in 2027, and another 15 in 2028. The program is designed to grow cumulatively each year, adding more drugs to the negotiated price framework as each cycle completes.

Q: What is the Medicare Part D out-of-pocket cap in 2026? A: Starting January 1, 2026, Medicare Part D has a hard $2,100 annual out-of-pocket cap. Once you spend $2,100 on covered drugs in a calendar year, your cost-sharing drops to zero for the rest of the year. This cap is separate from — and in addition to — the savings from negotiated drug prices.