The 15 drugs with negotiated Medicare prices from 2027
CMS's maximum fair price for each of the 15 Part D drugs negotiated for 2027, beside the 2024 list price and the reduction — plus the four that leave.
Filter by brand name or by condition. Prices are CMS's for a 30-day supply: the 2024 list price beside the maximum fair price that applies from January 1, 2027.
| Selected drug | Commonly treated conditions | List price, 2024 | Negotiated, 2027 | Reduction |
|---|---|---|---|---|
| Ozempic; Rybelsus; Wegovy | Type 2 diabetes; cardiovascular disease; obesity/overweight | $959 | $274 | 71% |
| Trelegy Ellipta | Asthma; chronic obstructive pulmonary disease | $654 | $175 | 73% |
| Xtandi | Prostate cancer | $13,480 | $7,004 | 48% |
| Pomalyst | Multiple myeloma; Kaposi sarcoma | $21,744 | $8,650 | 60% |
| Ofev | Idiopathic pulmonary fibrosis | $12,622 | $6,350 | 50% |
| Ibrance | Breast cancer | $15,741 | $7,871 | 50% |
| Linzess | Chronic idiopathic constipation; irritable bowel syndrome with constipation | $539 | $136 | 75% |
| Calquence | Chronic lymphocytic leukemia / small lymphocytic lymphoma; mantle cell lymphoma | $14,228 | $8,600 | 40% |
| Austedo; Austedo XR | Chorea in Huntington's disease; tardive dyskinesia | $6,623 | $4,093 | 38% |
| Breo Ellipta | Asthma; chronic obstructive pulmonary disease | $397 | $67 | 83% |
| Xifaxan | Hepatic encephalopathy; irritable bowel syndrome with diarrhea | $2,696 | $1,000 | 63% |
| Vraylar | Bipolar I disorder; major depressive disorder; schizophrenia | $1,376 | $770 | 44% |
| Tradjenta | Type 2 diabetes | $488 | $78 | 84% |
| Janumet; Janumet XR | Type 2 diabetes | $526 | $80 | 85% |
| Otezla; Otezla XR | Oral ulcers in Behçet's disease; plaque psoriasis; psoriatic arthritis | $4,722 | $1,650 | 65% |
The maximum fair price is a ceiling on what the manufacturer may charge a Part D plan — not your copay. Your share still comes from the plan's deductible, the drug's tier and its copay or coinsurance, so two people on the same drug can pay different amounts. The price is also set per dosage form and strength, which is why CMS publishes a package-level file alongside this table.
The maximum fair price applies per dosage form and strength. Three of the published package prices, from the same CMS file:
- Ozempic, 4 mg/3 mL pen — $276.78
- Rybelsus, 7 mg, 30-tablet package — $276.78
- Wegovy, 2.4 mg/0.75 mL, four pens — $385.63
A selected drug stops being selected once the FDA has approved a generic or licensed a biosimilar naming it as the reference product and that product is marketed. That is a statutory trigger, not a policy reversal — and it means the 2026 negotiated price will not be there in 2027.
| Selected drug | Determination | Removal effective |
|---|---|---|
| Stelara | October 2025 | January 1, 2027 |
| Entresto | October 2025 | January 1, 2027 |
| Xarelto | October 2025 | January 1, 2027 |
| NovoLog; NovoLog FlexPen; NovoLog PenFill; Fiasp; Fiasp FlexTouch; Fiasp PenFill | March 2026 | January 1, 2027 |
| Xeljanz; Xeljanz XR | June 2026 | January 1, 2029 |
The last row is here for completeness: Xeljanz was selected for the third cycle and has already been deselected, with removal set for 2029. It is not one of the January 1, 2027 departures.
Fifteen more Part D drugs get a negotiated price on January 1, 2027, and four drugs that carried one in 2026 lose it on the same day. The table above is CMS’s own price list, made searchable: the 2024 list price for a 30-day supply beside the maximum fair price that applies from January.
It is worth being precise about what the number is, because the headline percentage is the part that misleads.
A ceiling, not a copay
The statute calls the negotiated figure the maximum fair price. It caps what a manufacturer may charge for a selected drug when it is dispensed to someone with Medicare drug coverage. Your share is a different question entirely: it is set by your plan’s deductible, the tier the drug sits on, and its copay or coinsurance.
So a 71% reduction in the price of a drug does not mean a 71% reduction in what you pay. The savings figure CMS publishes — about $685 million in enrollee out-of-pocket costs in 2027 — is modelled “under the defined standard benefit design”, which is a standard-benefit assumption and not a promise about any particular plan.
Three other limits are worth keeping in view:
- It is not a cash price, and it does not set prices outside Medicare. A commercial plan or an uninsured purchase is governed by something else.
- It is per dosage form and strength. The per-drug figure in the table is a reference; the package file is what a pharmacy works from.
- It does not cover drugs given in a clinic. The first two cycles are Part D. Drugs Medicare pays for under Part B are part of the third cycle, and CMS says any negotiated prices there become effective beginning in 2028.
The count that does not match the list
CMS describes the second cycle as bringing the program to 25 negotiated drugs — the ten selected for 2026 plus the fifteen for 2027. That is correct as a count of what has been negotiated. It is not the number in force on January 1, 2027, because four of the first-round drugs leave the list that day. The number carrying a maximum fair price from January is 21.
The reason is in the statute rather than in policy: a selected drug is dropped once the FDA has approved a generic or licensed a biosimilar naming it as the reference product, and that product is marketed. That is also why the departure list above includes a row for 2029 — Xeljanz, selected in the third cycle, has already been deselected.
What else moves on January 1
The negotiation is not the only Part D number that changes. The standard benefit parameters for 2027, from the rate announcement CMS published on April 6, 2026:
| Standard Part D benefit | 2026 | 2027 |
|---|---|---|
| Deductible | $615 | $700 |
| Annual out-of-pocket threshold | $2,100 | $2,400 |
| Initial-coverage coinsurance | 25% | 25% |
Both of the moving figures are set by the statutory formula rather than by an annual policy choice. Beneficiaries with the full Low-Income Subsidy have a $0 deductible in both years. And these are the statutory reference amounts: your plan’s own deductible and threshold are in its 2027 materials.
That is how “the negotiated price lowered my drug” and “my Part D costs went up” can both be true in the same year.
What to do with this table before December 7
Medicare open enrollment runs October 15 to December 7, 2026, and every change above takes effect January 1.
- Find your drug in the table, then ignore the percentage and go to your plan’s 2027 tier and cost-sharing line. The Plan Finder on Medicare.gov is where that lives.
- If your drug is on the departure list, ask what the covered product is for 2027 and what it costs.
- Add the deductible and the out-of-pocket threshold to any comparison — a plan that looks cheaper on premiums can cost more once tier placement is in.
- If your drug costs land early in the year, ask about the Medicare Prescription Payment Plan. Every Part D plan offers it, it is voluntary and free, and it spreads out-of-pocket costs across the calendar year. It changes when you pay, not what you owe.
- Hang up on anyone offering to enroll you in the new prices. There is no enrollment, no application and no fee.
The full account — the negotiation timeline, the 2028 selection and the four departures in context — is in Medicare’s second round of negotiated drug prices. The plan-shopping checklist is in Medicare open enrollment 2027, and the arithmetic of a deductible against a copay is in Deductible, coinsurance, out-of-pocket max.
Frequently asked questions
- Is the negotiated price what I will pay at the pharmacy?
- No. The maximum fair price is a ceiling on what a manufacturer may charge for a selected drug when it is dispensed to someone with Medicare drug coverage. What you pay still runs through your plan's benefit design — the deductible, the drug's tier, your copay or coinsurance, the formulary and the pharmacy network. Two people on the same drug in different plans can pay different amounts on the same day.
- Why does the price change between packages of the same drug?
- Because the maximum fair price is applied per dosage form and strength, not as one flat number per drug. CMS publishes a file showing the price for each package. For one example, the per-package maximum fair prices are $276.78 for a 4 mg/3 mL Ozempic pen, $276.78 for a 30-tablet package of 7 mg Rybelsus, and $385.63 for four 2.4 mg/0.75 mL Wegovy pens.
- Four drugs lose their negotiated price in 2027. Is that the program being rolled back?
- No. A selected drug stops being selected once the FDA has approved a generic — or licensed a biosimilar — that names it as the reference product and that product is marketed. That is a statutory trigger. For a patient, it means the maximum fair price is gone and a competing product may sit on a different tier with a different copay, which is a question for the plan or the pharmacist rather than an assumption.
- Does the negotiated price lower the rest of my Part D costs?
- No, and one moving part runs the other way. The standard Part D deductible rises from $615 in 2026 to $700 in 2027, and the annual out-of-pocket threshold rises from $2,100 to $2,400. Both are set by the statutory formula in the 2027 rate announcement, and both are the standard benefit amounts rather than your plan's own figures.
Sources
- Centers for Medicare & Medicaid Services, 'Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2027' (fact sheet) — the 15 selected drugs, their maximum fair prices for a 30-day supply, the 2024 list prices, and the projected savings (cms.gov/files/document/fact-sheet-negotiated-prices-ipay-2027.pdf)
- CMS, 'Selected Drugs and Negotiated Prices' — the cycle-by-cycle selected drug lists and the deselection determinations with their removal effective dates (cms.gov/initiatives/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/selected-drugs-negotiated-prices)
- CMS, 'Announcement of Calendar Year (CY) 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies' (April 6, 2026), Attachment V — the 2027 Part D deductible, annual out-of-pocket threshold and initial-coverage coinsurance (cms.gov/files/document/2027-announcement.pdf)
- Inflation Reduction Act of 2022, Public Law 117-169, sections 11001-11002 (August 16, 2022) — added sections 1191-1198 of the Social Security Act, 42 U.S.C. 1320f to 1320f-7, which establish the negotiation program (govinfo.gov/content/pkg/PLAW-117publ169/html/PLAW-117publ169.htm)
- Medicare.gov, 'Medicare drug coverage (Part D)' and 'What's the Medicare Prescription Payment Plan?' — what plans cover and the monthly payment option for out-of-pocket drug costs (medicare.gov/health-drug-plans/part-d; medicare.gov/prescription-payment-plan)