Dear Readers,
Today’s newsletter is a brief Thanksgiving edition, highlighting a recent drug pricing announcement from the Center for Medicare Services (CMS). We will return in two weeks with our regular edition containing drug safety news and more.
Newly negotiated, much lower prices for 15 drugs will go into effect in January 2027 for patients with Medicare insurance. CMS says the negotiated prices will save taxpayers roughly $12 billion a year compared with this year’s prices. For example, the cost to Medicare for Novartis’ Ozempic will drop from $959 a month per patient to $274 per month. In 2024, 2.3 million Medicare patients age 65 and up took Ozempic. Here are some more examples of monthly price reductions:
Trelegy Elipta, for asthma and COPD: $654 to $175 (GSK)
Breo Elipta, for asthma and COPD: $397 to $67 (GSK)
Linzess, for chronic constipation: $539 to $136 (AbbVie)
Xtandi, for prostate cancer: $13,480 to $7004 (Astellas)
These new prices are the list price Medicare will pay, representing an upper level cap for patients; patient out-of-pocket prices might be lower, depending on their specific “Part D” (Medicare medications) plan. For example, if a Medicare patient who has met his deductible is required to pay 25% of the drug cost as a co-pay, with current prices Ozempic would be 25% of $959 or $235. With the new pricing in 2027 and the same 25% co-pay, it would be just $68 a month. Some of the drugs will be new options for Medicare patients, since all Part D plans will be required to offer access to the drugs. Check here for the complete list of the 15 drugs, old and new prices, and number of Medicare patients taking each of the drugs:
CMS: Fact Sheet with Drugs and Prices for 2027
CMS Press Release (November 25, 2025) : “CMS Delivers Savings for Seniors on 15 Major Drugs for Cancer and Chronic Disease”
Lower Prices for 10 Drugs in January 2026
While you’ll have to wait another year for the lower prices on Ozempic, Linzess, and other drugs mentioned above, you only have to wait about a month for reduced prices on ten others, listed below. In August 2024, CMS announced the first ten drugs with newly negotiated lower prices. These new prices, listed below, will take effect in January 2026 and represent a monthly (30 day) price:
Eliquis, for blood clots: price reduced from $521 to $231 (Bristol Meyers Squibb)
Entresto, for heart failure $628.00 to $295.00 (Novartis)
Enbrel, for rheumatoid arthritis: $7,106 to $2,355 (Immunex)
Farxiga for Type 2 diabetes: $556.00 to $178 (AstraZeneca)
Imbruvica, for blood cancer: $14,934 to $9319 (Pharmacycles)
Januvia, for Type 2 diabetes: $527 to $113 (Merck)
Jardiance, for diabetes: $573 to $197 (Boehringer Ingelheim)
Novolog insulin pens (various) for Type 2 diabetes: $495 to $119 (Novartis)
Stelara, for rheumatoid arthritis and ulcerative colitis: $13,836.00 to $4,695.00 (Jannsen)
Xarelto for blood clots: $517 to $197 (Janssen)
The new prices are the list price Medicare will pay, representing an upper level cap for patients; patient out-of-pocket prices might be lower, depending upon a person’s prescription (Part D) plan. All Medicare patients will have access to the drugs. In 2025, patients had an out-of-pocket cap of $2,000 for medications; this will rise to $2,100 in 2026. Like last year, Medicare patients in 2026 won’t have to worry about the “donut hole,” a situation where prior to 2025, some patients had to pay thousands of dollars out-of-pocket until they reached a “catastrophic limit” of over $6,000. Check this CMS fact sheet for total expenditures by brand name drug, number of patients taking, and more:
Fact sheet on 2026 Negotiated Lower Drug Prices (CMS)
Did you miss our last newsletter? Read it here:
