CMS names 15 high-cost drugs—including Botox and Trulicity—for 2026 Medicare price negotiations, with new prices effective in 2028

The Centers for Medicare & Medicaid Services (CMS) announced on January 27, 2026, that it has selected 15 high-cost prescription drugs for the third cycle of Medicare drug price negotiations, with negotiations set to occur in 2026 and the resulting negotiated prices taking effect on January 1, 2028. The selection includes widely used medicines spanning multiple therapeutic areas, including Botox and the diabetes drug Trulicity.

CMS said this round is notable because it includes, for the first time, drugs payable under Medicare Part B in addition to Medicare Part D drugs. The agency framed the move as part of efforts to reduce prescription drug costs for seniors and taxpayers, while also emphasizing that negotiations will incorporate factors such as clinical benefit, alternative treatments, unmet medical need, and impacts on Medicare populations.

According to CMS, the selected drugs were used by about 1.8 million people with Medicare Part D or Part B coverage over a recent measurement period and accounted for roughly $27 billion in combined Medicare spending under Parts B and D. CMS also said it is releasing a list of the top 50 negotiation-eligible drugs by combined expenditures, and the 15 selected drugs represent the highest-spending items on that list.

Selected drugs for the 2026 negotiation cycle (prices effective 2028)

• Anoro Ellipta
• Biktarvy
• Botox; Botox Cosmetic
• Cimzia
• Cosentyx
• Entyvio
• Erleada
• Kisqali
• Lenvima
• Orencia
• Rexulti
• Trulicity
• Verzenio
• Xeljanz; Xeljanz XR
• Xolair

CMS also selected Tradjenta for renegotiation, describing this as the first cycle of renegotiations under the program’s rules. Drug companies with selected products have a participation decision deadline of February 28, 2026, after which negotiations proceed with timelines aimed at implementing new prices in 2028.