Medicare 2026

The First 10 Medicare Negotiated Drugs: What Eliquis, Jardiance, Xarelto and the Others Mean for You

For the first time, Medicare has negotiated prices directly with drug manufacturers for a group of widely used medications. Those negotiated prices took effect on January 1, 2026, and they apply to 10 drugs that treat common conditions like blood clots, diabetes, heart failure, autoimmune disease and certain blood cancers. If you take one of these medications — or help someone who does — here is a plain-English look at what changed, what did not, and how it fits into the rest of Part D.

The 10 drugs and their new negotiated prices

Each price below is for a 30-day supply, shown next to the 2023 list price so you can see the change. These are the prices manufacturers must make available to Medicare and to the pharmacies that dispense the drug.

• Eliquis (blood clots): $231, from a list price of $521. About 3,928,000 people with Part D used Eliquis in 2023 — more than any other drug on this list.
• Jardiance (diabetes, heart failure, chronic kidney disease): $197, from $573.
• Xarelto (blood clots; risk reduction in coronary or peripheral artery disease): $197, from $517.
• Januvia (diabetes): $113, from $527.
• Farxiga (diabetes, heart failure, chronic kidney disease): $178.50, from $556.
• Entresto (heart failure): $295, from $628.
• Enbrel (rheumatoid arthritis, psoriasis, psoriatic arthritis): $2,355, from $7,106.
• Imbruvica (blood cancers): $9,319, from $14,934.
• Stelara (psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis): $4,695, from $13,836.
• Fiasp and NovoLog insulins (diabetes): $119, from $495.

CMS estimated that if these negotiated prices had been in effect in 2023, Medicare would have spent about $6 billion less — roughly 22 percent — on these medications. CMS also projected that people with Part D would save about $1.5 billion in out-of-pocket costs in 2026.

Important: the negotiated price is not your copay

This is the point most people miss. The law calls the negotiated amount a "maximum fair price." It is the price the manufacturer must make available to Medicare and to pharmacies. It is not automatically what you pay at the counter.

What you pay still depends on your Part D plan's rules:

• Whether you have met the plan's deductible (no plan may charge more than $700 as a deductible in 2027).
• What tier the drug sits on in your plan's formulary.
• The copay or coinsurance your plan sets for that tier.
• Whether you have hit the Part D out-of-pocket cap, which is $2,100 in 2026 and $2,400 in 2027. Once you reach the cap, you pay $0 for covered Part D drugs the rest of the year.

Because every Part D plan — including the drug coverage inside Medicare Advantage plans — must list these 10 drugs on its formulary, you should not be told the drug is simply "not covered." But cost sharing can still vary from plan to plan.

What happens to the price over time

A negotiated price stays in effect as long as the drug remains in the program. After the first year, it is adjusted annually by the change in the Consumer Price Index for All Urban Consumers (CPI-U), and CMS publishes the updated prices.

How this fits into choosing coverage

Annual Enrollment for 2027 runs October 15 – December 7, 2026, and any changes take effect January 1, 2027. Even if you are happy with your current coverage, it is worth checking your plan's formulary and pharmacy cost sharing for any of these 10 drugs you take.

Some program numbers for 2027 that are already set:

• Part D out-of-pocket cap: $2,400.
• Maximum Part D deductible any plan may charge: $700.
• Part D base beneficiary premium (used in the late-enrollment penalty calculation; actual plan premiums are set plan by plan): $41.33.
• Social Security COLA for benefits payable beginning January 2027: 3.6 percent, announced October 14, 2026.

The 2027 Part B standard premium and deductible, and the IRMAA income brackets, had not been released at the time of writing. CMS typically announces those figures in the fall, so check Medicare.gov for the official numbers before making final decisions.

Original Medicare + Medigap, or Medicare Advantage?

Both paths cover these negotiated drugs through Part D, but they work differently. Original Medicare paired with a Medigap policy and a stand-alone Part D plan generally offers broad provider access and more predictable cost sharing on the medical side, but Medigap premiums are an added monthly cost and Medigap does not cover drugs. Medicare Advantage plans bundle medical and (usually) drug coverage, often with extra benefits, but typically use provider networks and prior authorization. Neither is "better" in the abstract — the right fit depends on your doctors, your medications, your budget and how you like to get care.

If you have Medicaid or Extra Help

Since 2025, you have a monthly Special Enrollment Period to switch stand-alone Part D plans or move from Medicare Advantage to Original Medicare with a stand-alone Part D plan. If you have full Medicaid benefits, you can also join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month. You do not have to wait for Annual Enrollment to make a change.

Where to go next

For official plan details, formularies and the latest 2027 figures as they are announced, go to Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048), available 24 hours a day, 7 days a week. Reviewing your Annual Notice of Change from your current plan each fall is one of the simplest ways to catch cost or coverage changes before January 1.