Medicare drug price negotiation
The Inflation Reduction Act lets Medicare negotiate prices for selected high-spend drugs. Below is every drug with a negotiated Maximum Fair Price — the ceiling for what Part D plans and pharmacies pay for a 30-day supply — next to what Part D plans were actually paying per prescription before negotiation.
ⓘ How this was built
- CMS Maximum Fair Price file (negotiated prices, effective dates)
- CMS Medicare Part D spending dashboard (average spend per claim, by brand)
One row per negotiated drug: the MFP in force today (the file carries annual inflation updates), or the announced price for cohorts not yet effective. The before-price is Part D average gross spend per claim in the latest full year before the drug's price year, matched by brand name. *Claims can span 30–90 days while the MFP is per 30-day supply, so the percentage overstates the true per-supply cut for drugs commonly filled for 90 days; gross spend also excludes confidential rebates that plans already received.
Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.
Selected — price not yet announced
CMS publishes each cohort's negotiated prices about a year before they take effect; these drugs are in the program but still in negotiation.
2026 cohort prices first apply in 2026
| Drug | Ingredient | MFP / 30-day supply | Part D paid / Rx (year) | Est. net of rebates† | Change* | Status |
|---|---|---|---|---|---|---|
| Eliquis | Apixaban | $231 | $863 (2024) | $518–$648 | −73% | in force (updated Jan 1, 2026) |
| Enbrel | Etanercept | $2,355 | $7,827 (2024) | $4,696–$5,870 | −70% | in force (updated Jan 1, 2026) |
| Entresto | Valsartan / Sacubitrilat | $295 | $1,031 (2024) | $619–$773 | −71% | in force (updated Jun 1, 2026) |
| Farxiga | Dapagliflozin | $179 | $939 (2024) | $563–$704 | −81% | in force (updated Jan 1, 2026) |
| Imbruvica | Ibrutinib | $9,319 | $15,478 (2024) | $9,287–$11,609 | −40% | in force (updated Jan 1, 2026) |
| Januvia | Sitagliptin | $113 | $946 (2024) | $567–$709 | −88% | in force (updated Jan 1, 2026) |
| Jardiance | Empagliflozin | $197 | $1,006 (2024) | $604–$754 | −80% | in force (updated Jan 1, 2026) |
| Novolog | Insulin Aspart, Human | $119 | $769 (2024) | $461–$577 | −85% | in force (updated Jan 1, 2026) |
| Stelara | Ustekinumab | $4,695 | — | — | — | in force (updated Jan 1, 2026) |
| Xarelto | Rivaroxaban | $197 | $936 (2024) | $561–$702 | −79% | in force (updated Jan 1, 2026) |
2027 cohort prices first apply in 2027
| Drug | Ingredient | MFP / 30-day supply | Part D paid / Rx (year) | Est. net of rebates† | Change* | Status |
|---|---|---|---|---|---|---|
| Austedo | Deutetrabenazine | $4,093 | $6,577 (2024) | $3,946–$4,933 | −38% | from Jan 1, 2027 |
| Breo Ellipta | Fluticasone; Vilanterol | $67 | $520 (2024) | $312–$390 | −87% | from Jan 1, 2027 |
| Calquence | Acalabrutinib | $8,600 | $13,759 (2024) | $8,256–$10,319 | −37% | from Jan 1, 2027 |
| Ibrance | Palbociclib | $7,871 | $15,471 (2024) | $9,283–$11,603 | −49% | from Jan 1, 2027 |
| Janumet | Metformin; Sitagliptin | $80 | $953 (2024) | $572–$715 | −92% | from Jan 1, 2027 |
| Linzess | Linaclotide | $136 | $791 (2024) | $474–$593 | −83% | from Jan 1, 2027 |
| Ofev | Nintedanib | $6,350 | $12,902 (2024) | $7,741–$9,676 | −51% | from Jan 1, 2027 |
| Otezla | Apremilast | $1,650 | $4,897 (2024) | $2,938–$3,673 | −66% | from Jan 1, 2027 |
| Ozempic | Semaglutide | $274 | $1,510 (2024) | $906–$1,132 | −82% | from Jan 1, 2027 |
| Pomalyst | Pomalidomide | $8,650 | $21,797 (2024) | $13,078–$16,348 | −60% | from Jan 1, 2027 |
| Tradjenta | Linagliptin | $78 | $779 (2024) | $468–$585 | −90% | from Jan 1, 2027 |
| Trelegy Ellipta | Fluticasone; Umeclidinium; Vilanterol | $175 | $847 (2024) | $508–$635 | −79% | from Jan 1, 2027 |
| Vraylar | Cariprazine | $770 | $1,481 (2024) | $889–$1,111 | −48% | from Jan 1, 2027 |
| Xifaxan | Rifaximin | $1,000 | $2,779 (2024) | $1,668–$2,084 | −64% | from Jan 1, 2027 |
| Xtandi | Enzalutamide | $7,004 | $13,301 (2024) | $7,981–$9,976 | −47% | from Jan 1, 2027 |
Looking for what Part D plans pay day to day, and where? Medicare Part D drug prices has negotiated point-of-sale prices, coverage and prior-authorization rates, and spending by state.
*Part D claims can cover 30–90 days of supply while the MFP is per 30-day supply, so the percentage overstates the cut for drugs commonly dispensed in 90-day fills. Spend per claim is gross — before the confidential rebates plans already received — so the change vs plans' true net cost is smaller than shown.
†Estimated from MedPAC's program-wide rebate aggregates (June 2023: DIR = 29% of gross Part D spending; brand rebates ≈ 25–40% of gross, generics minimal). Actual rebates are confidential and vary widely by drug — this is a range, not a fact about this drug.