Medicare selects 15 more drugs, including Trulicity, for its next round of price talks

The Centers for Medicare & Medicaid Services on January 27, 2026 selected 15 more prescription drugs for Medicare price negotiation, the program's third cycle and the first to include drugs covered under Medicare Part B ^[2]. Negotiations with manufacturers run during 2026, and any negotiated prices take effect January 1, 2028 ^[2].

The selected drugs are Anoro Ellipta, Biktarvy, Botox and Botox Cosmetic, Cimzia, Cosentyx, Entyvio, Erleada, Kisqali, Lenvima, Orencia, Rexulti, Trulicity, Verzenio, Xeljanz and Xeljanz XR, and Xolair ^[2]. They are used for type 2 diabetes, HIV, asthma, arthritis, psoriasis, Crohn's disease, several types of cancer and other conditions ^[1]. Trulicity, a GLP-1 medicine for type 2 diabetes, had the largest footprint of the 15: 617,000 Medicare users and $4.9 billion in total Part B and Part D spending from November 2024 through October 2025 ^[1].

Across all 15, about 1.8 million people with Medicare used the drugs during that period, and total spending was about $27 billion, roughly 6% of all Part B and Part D spending ^[1][2]. CMS also named one already-negotiated drug, Tradjenta, for renegotiation ^[2].

Counting this group, 40 drug products have now been selected across the program's three cycles. Together they accounted for 36% of all Medicare Part B and Part D drug spending in 2024, or $125 billion out of $350 billion ^[1]. Negotiated prices for the first cycle's 10 Part D drugs took effect January 1, 2026; CMS estimated those prices would have saved Medicare $6 billion, a 22% net reduction, if they had been in effect in 2023, and that beneficiaries will save $1.5 billion in 2026 ^[1]. The second cycle covered 15 Part D drugs, including Ozempic and Wegovy, with prices effective January 1, 2027 ^[1]. CMS said those prices would have saved an estimated $8.5 billion in net covered drug costs in 2024, about 36% lower net spending ^[2]. KFF describes CMS's estimate as $12 billion, or 44% lower net spending relative to existing net prices ^[1]. The figures differ and rest on different bases: CMS's number includes Coverage Gap Discount Program spending ^[2], while the figure cited by KFF is measured against net prices ^[1].

Two features of this cycle are new. It is the first year CMS negotiates physician-administered Part B drugs, and the first year a change to the orphan-drug exclusion in the 2022 Inflation Reduction Act is in effect; the 2025 reconciliation law broadened that exclusion and exempted more drugs from negotiation ^[1].

Why it matters for patients

Nothing changes right away for people who take these 15 drugs. Their negotiated prices do not start until January 1, 2028 ^[1][2], and per-drug prices for this group have not been disclosed because the negotiations have not happened yet ^[2]. CMS published explanations of its negotiated prices and the factors considered after the first cycle ^[1].

For Medicare members who take a GLP-1 medicine, the new list includes Trulicity but no semaglutide or tirzepatide product ^[2]. The semaglutide drugs Ozempic and Wegovy were selected in the second cycle, and their negotiated prices take effect January 1, 2027 ^[1]. CMS has estimated beneficiary savings of $1.5 billion in 2026 from the first cycle and $685 million in 2027 from the second ^[1]. No comparable beneficiary savings estimate for the 2028 group has been released.

What happens next

• Drugmakers with a selected drug have until February 28, 2026 to decide whether to participate in negotiations, which take place during 2026 ^[2].
• January 1, 2027: negotiated prices for the second cycle's 15 Part D drugs, including Ozempic and Wegovy, take effect ^[1].
• January 1, 2028: negotiated prices for the 15 drugs named on January 27, 2026 take effect, along with any renegotiated price for Tradjenta ^[1][2].
• Starting in 2027 and each year after, up to 20 more Part B or Part D drugs can be selected, so the number of drugs with negotiated prices keeps growing ^[1].