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First 10 drugs for Medicare price negotiation announced under IRA

By Corey Ford, MHA

Inflation Reduction Act Implementation Update: 2026 Price Negotiation Drugs Announced by CMS
Corey Ford, Vice President of Reimbursement and Policy Insights

On Tuesday, August 29, 2023 the Centers for Medicare & Medicaid Services announced the 10 Part D drugs selected for the Medicare Drug Price Negotiation Program during the 2026 plan year. For the first time in history, Medicare will directly negotiate a maximum fair price of select high expenditure, single source drugs without a generic or biosimilar equivalent. The 10 drugs include the following in the table below.  

Selected Drugs for Price Negotiations in Part D for 2026
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Drug name Commonly treated conditions Total Part D Gross Covered Prescription Drug Costs from June 2022-May 2023
Eliquis Prevention and treatment of blood clots
Jardiance Diabetes; Heart failure $7,057,707,000
Xarelto Prevention and treatment of blood clots; Reduction of risk for patients with coronary or peripheral artery disease $6,031,393,000
Januvia Diabetes $4,087,081,000
Farxiga Diabetes; Heart failure; Chronic kidney disease $3,268,329,000
Entresto Heart failure $2,884,877,000
Enbrel Rheumatoid arthritis; Psoriasis; Psoriatic arthritis $2,791,105,000
Imbruvica Blood cancers $2,663,560,000
Stelara Psoriasis; Psoriatic arthritis; Crohn’s disease; Ulcerative colitis $2,638,929,000
Fiasp; Fiasp FlexTouch; Fiasp PenFill;
NovoLog; NovoLog FlexPen; NovoLog PenFill
Diabetes $2,576,586,000

Manufacturers with a product on this list must immediately work to collate the necessary data to be submitted to CMS by October 3. It will be critically important for manufacturers to leverage data from dossiers to help demonstrate the effectiveness of its products against competitors. While the financial impact on the selected drugs and their manufacturers will be considerable for 2026, I think that the impact of the negotiation program and the broader Inflation Reduction Act extends well beyond these targeted drugs. Part D plan sponsors may seek greater price concessions from the competitors of these selected products to maintain formulary coverage, and commercial payers may also adopt similar pricing requirements. 

Potentially even more impactful for industry beyond the price negotiations, the Part D benefit redesign will usher in greater financial responsibilities for manufacturers and even narrower formularies with greater access restrictions.  Given the complexity of the implementation of the Inflation Reduction Act, it is critical to engage with a partner who not only can decipher the regulatory complexity, but help you prepare for 2025 and beyond.

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About The Author

Corey Ford, MHA
Vice President of Reimbursement and Policy Insights
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