Medicare 2026 Drug Price Cuts

Medicare’s first negotiated prescription drug prices are set to take effect in 2026, and millions of enrollees could pay less.

The initial group targets some of the highest-spend medications in Part D, and even if your medicine isn’t on the list, there are smart ways to cut your costs now.

How Medicare’s 2026 drug price cuts work

Under the Inflation Reduction Act, the Centers for Medicare & Medicaid Services (CMS) can negotiate prices for certain high-spend, single‑source drugs in Medicare. The first round applies to Part D medications, with negotiated “maximum fair prices” (MFPs) taking effect January 1, 2026. You can read CMS’s overview of the program here.

Who sees savings? People with Medicare Part D who take one of the selected medicines could see lower plan-negotiated prices and lower out-of-pocket costs, depending on their plan and where they are in the benefit during the year. These changes layer on top of other improvements (like a new out-of-pocket cap in 2025), so the total impact could be meaningful for many seniors and people with disabilities.

Key timing note: While lawsuits have challenged the negotiation authority, the 2026 implementation timeline remains on track as of today. Plans will incorporate MFPs into their pricing, and your actual copay or coinsurance will depend on your specific Part D plan design and pharmacy network.

10 medications slated for Medicare price cuts in 2026

CMS announced the first 10 Part D drugs selected for negotiation for 2026. Final negotiated prices will appear closer to 2026, but the selected medicines are set. For a plain‑English summary of the list, see this nonpartisan explainer from KFF here. The 10 drugs are:

• Eliquis (apixaban) – a blood thinner used to prevent and treat blood clots and reduce stroke risk in atrial fibrillation.
• Xarelto (rivaroxaban) – another widely used anticoagulant for clot prevention and treatment.
• Jardiance (empagliflozin) – for type 2 diabetes; also reduces risk of cardiovascular death and is used in heart failure.
• Farxiga (dapagliflozin) – for type 2 diabetes; also used for heart failure and chronic kidney disease.
• Januvia (sitagliptin) – a DPP‑4 inhibitor for type 2 diabetes.
• Trulicity (dulaglutide) – a GLP‑1 agonist injection for type 2 diabetes.
• Entresto (sacubitril/valsartan) – for certain types of chronic heart failure.
• Stelara (ustekinumab) – for plaque psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.
• Imbruvica (ibrutinib) – for certain blood cancers, including CLL and mantle cell lymphoma.
• Enbrel (etanercept) – for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis.

What this means in practice: If you take one of these medicines and have Part D, your plan will reflect the negotiated price once 2026 begins. Your cost at the counter will also be shaped by your plan’s tiering, preferred pharmacy network, and whether you’ve reached different phases of Part D coverage.

If your medication isn’t on the list: ways to save now

1) Compare plans and pharmacies

Drug coverage, tiers, and pharmacy networks vary a lot. Use the official Medicare Plan Finder to compare your exact medications, doses, and pharmacies by total yearly costs, not just premiums. You can search and enroll during open enrollment or when you qualify for a special enrollment period using the Plan Finder here.

2) Ask your prescriber about lower‑cost equivalents

• Switch to a generic or biosimilar when available.
• Consider a therapeutic alternative in a lower tier on your plan’s formulary.
• Ask if a 90‑day supply via mail order at a preferred pharmacy saves money.

If your drug is non‑preferred, your prescriber can request a tiering exception or other coverage determination; learn how Medicare Part D appeals and exceptions work here.

3) Check income‑based help

• Extra Help (Low‑Income Subsidy): Cuts premiums, deductibles, and copays for Part D. See if you qualify and apply here (also available via Social Security).
• State Pharmaceutical Assistance Programs (SPAPs): Some states offer additional aid that coordinates with Part D. Find your state’s program here.

4) Manufacturer and nonprofit assistance

• Search for patient assistance programs and copay cards at NeedyMeds or via individual drug makers’ websites (often under “patient support”).
• For expensive specialty drugs, check PAN Foundation and other disease‑specific charities for copay grants.

5) Cash‑price shopping (when it beats your plan)

You can ask the pharmacy for the cash price and compare it to your Part D copay. Sometimes using a discount coupon is cheaper than your plan price. Try tools like GoodRx to compare prices. Important: If you buy outside your Part D plan at a cash price, it usually won’t count toward your Part D out‑of‑pocket cap for the year.

Other Medicare drug savings for 2025–2026

• $2,000 Part D out‑of‑pocket cap in 2025: Starting in 2025, what you pay out of pocket for Part D covered drugs will be capped at $2,000 for the year, with an option to smooth costs monthly. Learn more from KFF here.
• Insulin capped at $35/month: Most Part D and Part B covered insulin now has a maximum $35 monthly copay. Details from Medicare.gov are here.
• Recommended adult vaccines at $0: ACIP‑recommended vaccines (like shingles and RSV for eligible adults) are covered with no Part D cost sharing. See coverage info here.

What to do next

• Check the list above to see if you take one of the 10 negotiated drugs for 2026.
• Run your meds through the Medicare Plan Finder to confirm which plan and pharmacy minimize your total yearly costs.
• Talk to your prescriber about generics, biosimilars, or lower‑tier alternatives—then ask your plan for a tiering exception if appropriate.
• Explore financial help via Extra Help, your state’s SPAP, and nonprofit copay aid.

The bottom line: 2026 Medicare drug price negotiations will directly lower costs for people on a targeted set of high‑spend medicines—and everyone else still has multiple, proven ways to pay less for prescriptions today.