The Drug Prices the Medicare Program Can Directly Negotiate
Posted on August 5, 2025 By Jeff Snyder
When the Inflation Reduction Act of 2022 was signed into law, it gave the Medicare program the novel ability to negotiate directly with manufacturers on certain drugs’ costs. The Medicare program will negotiate 10 Part D drugs for 2026, 15 Part D drugs for 2027, 15 more Part B or Part D drugs for 2028, and 20 more Part B or Part D drugs for 2029 and every year thereafter.
According to the bill, the criteria that drugs must meet to be eligible for negotiation are:
- Brand-name drugs or biologics
- Part of the 50 negotiation-eligible drugs with the highest total Medicare Part D spending
- Part of the 50 negotiation-eligible drugs with the highest total Medicare Part B spending
- Aren’t in one of the disqualifying categories:
- Drugs that have generic or biosimilar versions available
- Drugs less than nine years (small-molecular drugs) or 13 years (biologics) from FDA approval or licensure date
- Certain “small biotech drugs” (from 2026 to 2028)
- Drugs that amount to less than $200 million of the Medicare program spending in 2021
- Drugs with an orphan designation as their only FDA approval
We’ll continue to keep this list updated as more drugs are announced in the future so you can be aware which drugs the Medicare program can negotiate for directly.
Eliquis (2026)
Generic Name: Apixaban
Uses
Eliquis is an anticoagulant that is prescribed to help prevent serious blood clots (primarily deep vein thrombosis (DVT) and pulmonary embolus (PE) clots) and may prevent them from reforming. It can also lower your risk of having a stroke.
Jardiance (2026)
Generic Name: Empagliflozin
Uses
Jardiance can help treat type 2 diabetes by improving blood sugar levels, reducing the risk of cardiovascular death in adults with cardiovascular disease alongside type 2 diabetes, and reducing the risk of hospitalization and death in some adults with heart failure.
Xarelto (2026)
Generic Name: Rivaroxaban
Uses
Xarelto is an anticoagulant that can treat and prevent DVT and PE blood clots due to certain atrial fibrillation or hip or knee replacement surgery. It’s also used for limited-mobility, high-risk patients during or after inpatient care.
Januvia (2026)
Generic Name: Sitagliptin Phosphate
Uses
Januvia is used to help control high blood sugar in people with type 2 diabetes. It both increases the number of incretins in your body, a natural substance that helps control blood sugar, and decreases the amount of sugar your liver makes.
Farxiga (2026)
Generic Name: Dapagliflozin Propanediol
Uses
Farxiga is used to help control high blood sugar in people with type 2 diabetes. It’s also used to lower your risk of developing, and in the treatment of, chronic kidney disease and heart failure.
Entresto (2026)
Generic Name: Sacubitril-Valsartan
Uses
Entresto can help treat certain types of heart failure by relaxing the blood vessels, allowing the blood to flow more easily. This lessens the strain on your heart as it pumps blood through your body.
Enbrel (2026)
Generic Name: Etanercept
Uses
Enbrel is an injectable medicine that is used to treat certain types of autoimmune diseases like rheumatoid arthritis, psoriasis, and psoriatic arthritis.
Imbruvica (2026)
Generic Name: Ibrutinib
Uses
Ibrutinib is a class of drug called a kinase inhibitor that is used to treat certain types of cancers, specifically blood cancers. It slows the growth of cancer cells, sometimes even stopping the growth.
Stelara (2026)
Generic Name: Ustekinumab
Uses
Stelara is an injectable medicine that blocks proteins (interleukin-12 and interleukin-23) that can cause inflammation in certain conditions. It’s used to help treat psoriatic arthritis, Crohn’s disease, ulcerative colitis, and plaque psoriasis.
NovoLog and Fiasp (2026)
Generic Name: Insulin Aspart
Uses
Both NovoLog and Fiasp are injectable insulin used to help control high blood pressure in people with diabetes by replacing the insulin your body would normally create. The Medicare program can also negotiate for NovoLog FlexPen, NovoLog PenFill, Fiasp FlexTouch, and Fiasp PenFill.
Ozempic; Rybelsus; Wegovy (2027)
Generic Name: Semaglutide
Uses
Semaglutides are used to help lower and control blood sugar levels in people with type 2 diabetes and certain other conditions such as heart disease. Research has shown it can assist with weight loss and lowering risk of cardiovascular events. Semaglutides can be taken as an injection or pill, depending on the form or brand of semaglutide you are prescribed.
Trelegy Ellipta (2027)
Generic Name: Fluticasone/Umeclidinium/Vilaterol, Fluticasone Furoate/Umeclidinium/Vilanterol
Uses
Trelegy ellipta work together to reduce swelling in the lungs (fluticasone) and relax muscles around the airways (umeclidinium/vialterol) to help the user breathe easier. It is commonly used as a control inhaler for Asthma and Chronic Obstructive Pulmonary Disease (COPD).
Xtandi (2027)
Generic Name: Enzalutamide
Uses
Enzalutamide is an oral drug that fights the growth of prostate cancer. The drug blocks the effects of a hormone called androgens, which slows the growth of prostate cancer.
Pomalyst (2027)
Generic Name: Pomalidomide
Uses
Pomalidomide is an oral medication that is used to treat multiple myelome (MM) and AIDS-related Kaposi’s sarcoma (and Kaposi’s sarcoma in the HIV-negative) cancers. The drug empowers the immune system to detect and kill cancer cells in the bone marrow and promotes the growth of new non-cancerous blood cells.
Ibrance (2027)
Generic Name: Palbociclib
Uses
Palbociclib is an oral drug used to treat breast cancer, often in combination with other medications. It specifically treats advanced or metastatic breast cancer that is hormone-receptor-positive and HER2-negative.
Ofev (2027)
Generic Name: Nintedanib, Nintedanib esylate
Uses
Nintedanib is a kinase inhibitor that can treat chronic interstitial lung diseases (ILD) and idiopathic pulmonary fibrosis and SSC-ILD. It blocks the function of certain proteins from causing scarring in the lungs.
Linzess (2027)
Generic Name: Linaclotide
Uses
Linaclotide treats constipation in bowel problems like IBS, chronic idiopathic constipation, and functional constipation by increasing the fluid in the intestines. It can also help move food through the gut faster. It is taken an oral capsule.
Calquence (2027)
Generic Name: Acalabrutinib, Acalabrutinib Maleate
Uses
Acalabrutinib is an oral drug used in the treatment of cancers like mantel cell lymphoma, chronic lymphocytic leukemia, and small lymphocytic lymphoma. It is used to block a certain type of protein (BTK), slowing the growth of cancer cells.
Austedo; Austedo XR (2027)
Generic Name: Deutetrabenazine
Uses
Deutetrabenazine is an oral medication used in the treatment of certain movement disorders, such as Chorea and Tardive dyskinesia. By lowering neurotransmitter levels, it can lead to fewer uncontrolled movements in those conditions.
Breo Ellipta (2027)
Generic Name: Fluticasone/Vilanterol, Fluticasone furoate/Vilanterol Trifenatate
Uses
Fluticasone/vilanterol are inhaled powdered medicines that are used in maintenance inhalers for asthma or COPD. Fluticasone reduces swelling in the lungs while vilanterol relaxes the muscles around the airways.
Tradjenta (2027)
Generic Name: Linagliptin
Uses
Linagliptin is an oral tablet that can be taken along with diet and exercise to lower blood sugar levels in those with type-2 diabetes. The medication helps promote hormones in your body that regulate your insulin levels called incretins.
Xifaxan (2027)
Generic Name: Rifaximin
Uses
Rifaximin is used to treat certain bacterial-realted conditions such as travelers’ diarrhea, IBS with diarrhea, and hepatic encephalopathy. The medication kills certain types of bacteria that causes or contributes to these conditions. The drug is taken orally.
Vraylar (2027)
Generic Name: Cariprazine, Cariprazine HCl, Cariparzine Hydrochloride
Uses
Cariprazine commonly used in the treatment of major mental disorders like schizophrenia, bipolar 1, and depression. Taken orally, cariprazine is a second-generation antipsychotic that balances serotonin and dopamine in the brain.
Janumet; Janumet XR (2027)
Generic Name: Sitagliptin/Metformin, Sitagliptin PO4/Metformin HCl, Sitagliptin Phosphate/Metformin Hydrochloride
Uses
Sitagliptin/metformin helps to treat type-2 diabetes by lowering the blood sugar levels in the body. Taken as oral tablets, the drug can decrease the sugar absorbed by the body, reduces sugar from the liver, and both increases insulin in the body and makes it more efficient.
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