The 10 Drugs Medicare Is Targeting for Lower Prices

If you’re on Medicare, the high cost of prescription drugs is likely a major concern. You may have heard news about upcoming price cuts, and you clicked here to find out which specific medications are affected. This guide breaks down everything you need to know about the first 10 drugs selected for price negotiation by Medicare.

A Landmark Change in Drug Pricing

For the first time, thanks to the Inflation Reduction Act, Medicare has the power to directly negotiate the prices of certain high-cost prescription drugs with manufacturers. This is a significant shift designed to make essential medications more affordable for millions of older Americans and reduce overall government spending.

The process has officially begun, and the Centers for Medicare & Medicaid Services (CMS) has announced the first list of 10 drugs covered under Medicare Part D that will be subject to these negotiations. These medications were chosen because they account for a substantial portion of Medicare spending and are taken by millions of beneficiaries for chronic and serious health conditions. Let’s take a detailed look at each one.

The First 10 Drugs Selected for Negotiation

Here is the complete list of the initial 10 drugs targeted for price negotiation. The new, lower prices for these medications are scheduled to go into effect in 2026.

1. Eliquis (apixaban)

  • What it treats: Eliquis is a widely prescribed anticoagulant, or blood thinner. It is used to prevent blood clots, stroke, and embolism in patients with atrial fibrillation (an irregular heartbeat) and to treat deep vein thrombosis and pulmonary embolism.
  • Manufacturer: Bristol Myers Squibb / Pfizer

2. Jardiance (empagliflozin)

  • What it treats: Jardiance is used to manage type 2 diabetes by helping the kidneys remove glucose from the bloodstream. It is also prescribed to reduce the risk of cardiovascular death in adults with type 2 diabetes and heart disease, and to treat certain types of heart failure.
  • Manufacturer: Boehringer Ingelheim / Eli Lilly

3. Xarelto (rivaroxaban)

  • What it treats: Similar to Eliquis, Xarelto is another popular blood thinner. It is used to reduce the risk of stroke and blood clots in people with atrial fibrillation, treat deep vein thrombosis and pulmonary embolism, and prevent blood clots in patients after knee or hip replacement surgery.
  • Manufacturer: Johnson & Johnson (Janssen)

4. Januvia (sitagliptin)

  • What it treats: Januvia is an oral medication used to improve blood sugar control in adults with type 2 diabetes. It works by increasing the levels of natural substances called incretins, which help control blood sugar by increasing insulin release and decreasing the amount of sugar made by the liver.
  • Manufacturer: Merck

5. Farxiga (dapagliflozin)

  • What it treats: Farxiga is used to improve glycemic control in adults with type 2 diabetes. It has also been approved to reduce the risk of hospitalization for heart failure in adults with type 2 diabetes and cardiovascular disease, and to treat chronic kidney disease.
  • Manufacturer: AstraZeneca

6. Entresto (sacubitril/valsartan)

  • What it treats: Entresto is a combination medication used to treat certain types of heart failure. It works by relaxing blood vessels and helping the body get rid of excess sodium, which reduces the strain on the heart and helps it pump blood more effectively.
  • Manufacturer: Novartis

7. Enbrel (etanercept)

  • What it treats: Enbrel is a biologic medication used to treat several autoimmune conditions, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. It works by blocking a substance in the body that can cause inflammation.
  • Manufacturer: Amgen

8. Imbruvica (ibrutinib)

  • What it treats: Imbruvica is a targeted therapy drug used to treat certain types of cancer, including chronic lymphocytic leukemia (CLL) and mantle cell lymphoma. It works by blocking a protein that helps cancer cells live and grow.
  • Manufacturer: AbbVie / Johnson & Johnson (Janssen)

9. Stelara (ustekinumab)

  • What it treats: Stelara is a biologic medication used for the treatment of plaque psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis. It targets specific proteins in the immune system to reduce inflammation.
  • Manufacturer: Johnson & Johnson (Janssen)

10. Fiasp; Fiasp FlexTouch; Fiasp PenFill; Novolog; Novolog FlexPen; Novolog PenFill (insulin aspart)

  • What it treats: This group includes various fast-acting insulin products used to manage blood sugar levels in people with type 1 and type 2 diabetes. They are typically taken at mealtimes to control blood sugar spikes after eating.
  • Manufacturer: Novo Nordisk

The Timeline: When to Expect Lower Prices

It’s important to understand that these price cuts are not immediate. The new law established a clear timeline for this process.

  • 2023-2024: Medicare and the drug manufacturers will engage in a negotiation process to agree on a new “maximum fair price” for each of the 10 drugs listed above.
  • September 2024: The new negotiated prices will be publicly announced.
  • January 1, 2026: The new, lower prices for these 10 drugs will officially take effect for Medicare beneficiaries.

While 2026 may seem far away, this is a multi-year process involving complex negotiations. The good news is that this is just the beginning. The law mandates that more drugs will be selected for negotiation in the coming years, expanding the potential for savings.

Frequently Asked Questions

How were these 10 drugs chosen? The drugs were selected based on several criteria set by the law. They had to be single-source drugs without generic or biosimilar competition, have been on the market for several years, and be among the drugs with the highest total spending under Medicare Part D.

Will more drugs be added to the negotiation list later? Yes. The Inflation Reduction Act specifies that an additional 15 Part D drugs will be selected for negotiation for 2027, another 15 Part D and Part B drugs for 2028, and 20 more Part D and Part B drugs for each year after that.

Do I need to do anything to get these lower prices? No. If you are enrolled in a Medicare Part D plan and are prescribed one of these medications, the new negotiated price will be automatically applied starting in 2026. You will see the savings reflected in your out-of-pocket costs at the pharmacy.

What other cost-saving measures are available for Medicare beneficiaries? The Inflation Reduction Act included several other important benefits. For example, it capped the monthly cost of insulin at $35 for people on Medicare and will cap annual out-of-pocket drug costs at $2,000 for Part D enrollees starting in 2025. These provisions are already helping or will soon help millions of Americans afford their medications.