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Botox and the GLP-1 drug Trulicity are among the latest group of prescription drugs subject to price controls by Medicare.
The Centers for Medicare & Medicaid Services (CMS), the federal agency that runs Medicare, has selected 15 high-cost prescription drugs for government price negotiations. This is the first time the list includes drugs administered in doctors’ offices, not just medications that patients pick up at a pharmacy.
Negotiations with participating drug companies will take place in 2026, and any negotiated or renegotiated prices will go into effect in January 2028. Drug companies can technically choose not to participate in negotiations. However, companies that refuse face a steep federal excise tax, making opting out financially unrealistic.
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Under the Inflation Reduction Act (IRA), signed into law in 2022, Medicare was granted the authority to set lower prices for certain high-cost drugs covered by the program.
While the IRA refers to “negotiation,” the text of the legislation allows the CMS to set a “maximum fair price” for a drug. The pharmaceutical company then must “enter into agreement” for the price. If it does not, the government will assess a daily excise tax on every drug sold over the “maximum fair price.”
The move has faced criticism from drugmakers, including Novo Nordisk, which told FOX Business it “remains opposed to government price setting through the IRA and has significant concerns about how the law is being implemented by this administration, including aggregating multiple products that individually would not meet the requirements of the statute.”
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The agency noted that, during the previous cycle of negotiations announced in January 2025, CMS released a list of 15 high-cost Medicare Part D drugs selected for price negotiations, with the negotiated prices scheduled to take effect in January 2027. The agency said if those prices had been in place in 2024, Medicare would have saved an estimated $8.5 billion in net covered prescription drug costs, which is equivalent to a 36% reduction in total net spending.
CMS Administrator Dr. Mehmet Oz said in a statement that “seniors and taxpayers have paid the price for skyrocketing prescription drug costs” for too long and that the agency is “taking strong action to target the most expensive drugs in Medicare, negotiate fair prices, and make sure the system works for patients — not special interests.”
CMS is publishing a list of 50 drugs that cost Medicare the most. For the third round, CMS chose the 15 most expensive drugs in that overall list.
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Drug companies will have until Feb. 28, 2026, to comply or face a hefty tax.
The selected drug list for the third cycle of negotiations is:
- Anoro Ellipta
- Biktarvy
- Botox; Botox Cosmetic
- Cimzia
- Cosentyx
- Entyvio
- Erleada
- Kisqali
- Lenvima
- Orencia
- Rexulti
- Trulicity
- Verzenio
- Xeljanz; Xeljanz XR
- Xolair
The selected drug for renegotiation is:
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