Medicare names 15 drugs for next price negotiation cycle, including Botox and Trulicity

The Centers for Medicare & Medicaid Services (CMS) announced a new list of 15 high-cost prescription drugs targeted for Medicare price negotiations, a step intended to lower out-of-pocket costs and reduce government spending. Negotiations will take place during 2026 and, if finalized, the negotiated prices will take effect on January 1, 2028. The selection includes widely used treatments spanning respiratory disease, cancer, autoimmune conditions, HIV, and diabetes, as well as Botox and Botox Cosmetic.

CMS said this cycle expands the program by including, for the first time, drugs payable under Medicare Part B alongside medicines covered under Part D. That matters because Part B drugs are typically administered in doctors’ offices and outpatient settings, and their pricing dynamics can be different from retail pharmacy medications. CMS also selected one previously negotiated drug, Tradjenta, for the program’s first renegotiations.

The agency’s list of selected drugs includes Anoro Ellipta, Biktarvy, Botox/Botox Cosmetic, Cimzia, Cosentyx, Entyvio, Erleada, Kisqali, Lenvima, Orencia, Rexulti, Trulicity, Verzenio, Xeljanz/Xeljanz XR, and Xolair. CMS said the selected medicines represent the top 15 highest-spending drugs on a newly released list of 50 negotiation-eligible drugs based on combined expenditures under Medicare Parts B and D.

Drugmakers whose products were chosen must decide by February 28, 2026 whether they will participate in negotiations. CMS explained that it will consider several factors during talks, including clinical benefit, evidence about alternatives, how well a drug addresses unmet medical needs, and impacts on populations that rely on Medicare. CMS also considers information such as research and development costs, and current production and distribution costs, as part of the negotiation framework.

Supporters argue that negotiating prices for the most expensive drugs can deliver meaningful savings for beneficiaries and taxpayers, especially for therapies used by large numbers of seniors and people with disabilities. Critics, including some pharmaceutical industry voices, have warned that price controls could reduce incentives for innovation. With 2026 negotiations beginning soon, stakeholders across health care—patients, insurers, drugmakers, and providers—are likely to press CMS on how it balances affordability with access and future drug development.