The Trump administration has unveiled a list of 15 prescription medications selected for federal price negotiations under Medicare, a continuing effort by the U.S. government to reduce prescription drug costs for older adults and people with disabilities.
The list includes drugs used to treat Type 2 diabetes, HIV, arthritis, psoriasis, cancer, chronic lung disease, depression and other conditions. This third round of drug selections builds on earlier rounds and represents a strategic expansion of federal authority to negotiate drug prices directly with manufacturers.
Medicare’s drug price negotiation program was established under the Inflation Reduction Act of 2022, which gave the federal government the power to directly negotiate the prices of certain high-cost drugs covered under Medicare Part D (retail prescriptions) and for the first time in this round, Medicare Part B (medications administered in clinical settings such as doctor’s offices).
Prices negotiated now are scheduled to take effect beginning in 2028, and the expanded approach will bring the total number of price-negotiated drugs to about 40 once earlier and current selections are implemented.
The Centers for Medicare & Medicaid Services (CMS) selects drugs for negotiation based on total Medicare spending, age of the drug, and lack of generic or biosimilar alternatives. Manufacturers of selected drugs must decide whether to participate in negotiations by 28th February this year.
The 15 medications named in this round cover a broad range of therapeutic categories and include some of the most expensive and widely used products in the Medicare program. According to federal officials, nearly 1.8 million Medicare enrollees used these drugs between November 2024 and October 2025, and they together accounted for roughly 6 percent of total Medicare Part B and Part D spending during that period.
Drugs selected for this price negotiation cycle include:
Anoro Ellipta (chronic obstructive pulmonary disease)
Biktarvy (HIV)
Botox and Botox Cosmetic (migraine, overactive bladder, other Medicare-covered uses)
Cimzia (psoriatic arthritis)
Cosentyx (psoriasis)
Entyvio (ulcerative colitis, Crohn’s disease)
Erleada (prostate cancer)
Kisqali (breast cancer)
Lenvima (various cancers)
Orencia (arthritis)
Rexulti (depression, schizophrenia)
Trulicity (Type 2 diabetes)
Verzenio (breast cancer)
Xeljanz and Xeljanz XR (arthritis)
Xolair (asthma)
These drugs span conditions including metabolic disease, immune-mediated inflammatory disease, cancers of different types, chronic lung conditions and HIV, reflecting broad use among Medicare beneficiaries.
This new group of negotiated medications follows earlier rounds of the negotiation program:
First round: 10 drugs selected with prices negotiated under the law; negotiated prices for these went into effect in 2026, with substantial projected savings on commonly prescribed medicines such as GLP-1 diabetes and weight-loss drugs.
Second round: 15 additional drugs were selected previously with negotiated prices scheduled to take effect in 2027.
Under the IRA framework, negotiations will expand further in future years, with planned rounds increasing drugs subject to negotiation as the program matures.
Officials at the Centers for Medicare & Medicaid Services have emphasised that negotiated pricing aims to reduce out-of-pocket costs for beneficiaries and slow the growth of Medicare drug spending. AARP’s CEO, Dr. Myechia Minter-Jordan, described the latest announcement as a step toward meeting public demand for lower drug costs.
Pharmaceutical industry representatives, including critics from the trade association PhRMA, have expressed ongoing concerns about the negotiation process, asserting that government-led price setting may have broader implications for innovation and patient access.
Under the law, once drugs are selected:
CMS and the manufacturer enter negotiation to agree on a “maximum fair price” the government will pay.
If agreement is not reached, CMS may impose a price ceiling.
Negotiated prices then apply to Medicare Part B and Part D reimbursements starting on a designated future date (2028 for this round’s list).
Medicare beneficiaries and taxpayers are expected to benefit from lower prices and reduced spending on high-cost medications.
Medicare price negotiation represents a significant departure from U.S. policy for decades, as federal governments historically lacked authority to directly negotiate drug prices on behalf of the Medicare program. The IRA granted that authority in 2022 and set the stage for sequential implementation over multiple years.
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