Negotiated lower costs for 10 widely used prescription drugs under Medicare went into effect Thursday, marking the first implementation of price limits authorized by the 2022 Inflation Reduction Act. The changes cap what drug manufacturers can charge Medicare plans for select medications, but it remains unclear how much of those savings will flow directly to Medicare Part D and Medicare Advantage enrollees, given the complexity and opacity of drug pricing and reimbursement.
Under the law, the Department of Health and Human Services was required to negotiate maximum fair prices for 10 popular prescription drugs each year, beginning in 2026. Earlier this year, the Centers for Medicare and Medicaid Services (CMS) announced the first set of negotiated maximum prices, with reductions ranging from 38% to 79% below the drugs’ listed prices. List prices represent manufacturers’ sticker prices, but actual costs paid by insurers and patients are often different due to rebates, discounts, and other adjustments.
The 10 drugs covered by the initial negotiation round include medications used to prevent blood clots, treat diabetes, autoimmune conditions, blood cancers, and heart failure. They are: Eliquis, Enbrel, Entresto, Farxiga, Imbruvica, Januvia, Jardiance, NovoLog/Fiasp insulin, Stelara, and Xarelto.
Among the negotiated price changes, the blood thinner Eliquis — the most widely used drug on the list, with nearly 4 million Medicare Part D users in 2023 — saw its maximum price cut by 56%. The listed price for a 30-day supply dropped from $521 to $231 under the new negotiation.
Januvia, a diabetes medication, experienced the largest percentage reduction, with its list price falling from $527 to $113 for a month’s supply. Insulin products Fiasp and NovoLog, both manufactured by Novo Nordisk, saw their listed prices slashed by 76%, from $495 to $119 per month.
Imbruvica, a treatment for certain blood cancers used by about 17,000 Part D enrollees in 2023, saw the smallest negotiated reduction. Its list price dropped from $14,934 to $9,319 per month, a 38% decrease.
Whether Medicare beneficiaries see meaningful savings depends largely on the specific Part D or Medicare Advantage plan in which they are enrolled. Although all Part D plans and Advantage plans that include drug coverage are required to cover the 10 negotiated medications, out‑of‑pocket costs and benefit designs vary by insurer.
The Medicare Drug Price Negotiation Program is designed to reduce overall Medicare spending on prescription drugs and strengthen the long‑term financial stability of the program. As the policy continues to roll out, patients and lawmakers alike will be watching to see how effectively negotiated savings translate into lower costs at the pharmacy counter.
