Medicare picks 15 more drugs—including Botox and a GLP-1—for price negotiations effective in 2028
The Centers for Medicare & Medicaid Services has selected 15 high-cost drugs for the next round of Medicare price negotiations, including Botox and the diabetes drug Trulicity. The negotiations will take place in 2026, with any negotiated prices scheduled to start on January 1, 2028, expanding the program to include Part B drugs for the first time.
A new round of negotiations, with prices slated for 2028
The Centers for Medicare & Medicaid Services (CMS) announced a list of 15 high-cost prescription drugs selected for the third cycle of Medicare’s drug price negotiation program. The agency said negotiations will occur during 2026, and the negotiated prices are set to take effect on January 1, 2028.
The selection includes high-profile products such as Botox and the diabetes drug Trulicity, along with therapies used for conditions including cancer, autoimmune disease, and HIV. CMS also named one drug for renegotiation, marking an additional step in the program’s rollout.
Part B included for the first time
CMS said this cycle expands negotiations beyond Medicare Part D by including, for the first time, drugs payable under Medicare Part B. That matters because Part B covers many physician-administered medications, which can be expensive and widely used in outpatient care.
According to CMS, about 1.8 million people with Medicare Part D or Part B coverage used the selected drugs during the measurement window cited by the agency, and the products represent a significant share of Medicare spending. Supporters argue negotiations can ease costs for seniors and taxpayers, while industry groups have criticized the approach as government price-setting that could affect innovation incentives.
What happens next for manufacturers and patients
Drugmakers with products on the list must decide whether to participate in the negotiation process by February 28, 2026. CMS says it will weigh clinical benefit, alternative treatments, unmet medical need, and effects on populations that depend on Medicare, along with other factors such as research, production, and distribution costs.
For patients, the key point is timing: even though the list is being announced now, any negotiated prices are not scheduled to begin until 2028. In the near term, beneficiaries will likely see the debate shift to how steep the eventual discounts should be and how the changes could ripple through premiums, formularies, and out-of-pocket spending.
Key dates
- February 28, 2026: Deadline for drug companies to decide whether to participate.
- 2026: Negotiations conducted by CMS.
- January 1, 2028: Negotiated (and renegotiated) prices scheduled to take effect.