CMS will negotiate the prices for Trulicity, Biktarvy and 13 other high-cost medications commonly covered by Medicaid Parts B and D, according to a Jan. 27 news release from the agency.
The Medicare Drug Price Negotiation Program enacted its first cycle of negotiated drug prices on Jan. 1, 2026, which included four Type 2 diabetes medications. The 2027 cycle includes 15 medications, with Ozempic, Wegovy and Rybelsus topping the list.
To be eligible for negotiations, drugs must lack generic or biosimilar competition and be on the market for more than 10 years. The 2028 negotiation cycle will be the first time Medicare Part B medications are included, which are drugs administered in a hospital setting such as chemotherapy or anesthesia.
Here are the 15 medications selected for the 2028 cycle:
| Drug | Commonly treated conditions | Drug Medicare expenditure from November 2024 to October 2025 |
| Trulicity | Type 2 diabetes; Type 2 diabetes and cardiovascular disease or multiple cardiovascular risk factors | $4.9 billion |
| Biktarvy | HIV type 1 infection | $3.9 billion |
| Orencia | Psoriatic arthritis; rheumatoid arthritis | $2.5 billion |
| Cosentyx | Plaque psoriasis; psoriatic arthritis | $2.3 billion |
| Erleada | Prostate cancer | $1.9 billion |
| Kisqali | Breast cancer | $1.6 billion |
| Entyvio | Crohn’s disease; ulcerative colitis | $1.5 billion |
| Verzenio | Breast cancer | $1.4 billion |
| Botox; Botox Cosmetic | Chronic migraine; overactive bladder; spasticity; other movement disorders | $1.1 billion |
| Lenvima | Thyroid cancer; endometrial cancer; liver cancer; kidney cancer | $1.1 billion |
| Xolair | Asthma; chronic spontaneous urticaria | $1.1 billion |
| Rexulti | Major depressive disorder; schizophrenia; agitation associated with dementia due to Alzheimer’s disease | $1.1 billion |
| Xeljanz; Xeljanz extended-release | Psoriatic arthritis; rheumatoid arthritis; ulcerative colitis | $1 billion |
| Anoro Ellipta | Chronic obstructive pulmonary disease | $813 million |
| Cimzia | Crohn’s disease; plaque psoriasis; psoriatic arthritis; rheumatoid arthritis | $787 million |
In a separate move Jan. 27, HHS published a guidance for drug manufacturers with direct-to-consumer programs, which allow cash-paying patients to purchase discounted medications.
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