Medicare Targets 15 High-Cost Drugs from Eli Lilly, Pfizer, and AbbVie in Landmark Price Negotiations for 2028

The U.S. Centers for Medicare & Medicaid Services (CMS) announced on January 27, 2026, the selection of 15 branded prescription drugs for the third round of its Drug Price Negotiation Program, including key medications from Eli Lilly, Pfizer, and AbbVie. This move, under the Inflation Reduction Act (IRA) of 2022, aims to lower costs for Medicare beneficiaries on treatments for HIV, cancer, autoimmune diseases, and more, with negotiated prices set to take effect in 2028. For the first time, the list includes drugs covered under Medicare Part B, administered in outpatient settings.

Key Drugs Selected for Negotiation

CMS chose these 15 drugs based on high Medicare spending, lack of generic competition, and other statutory criteria, targeting products that cost the program billions annually. The roster features:

These selections highlight a focus on chronic conditions affecting millions of older Americans.

Program Background and Evolution

The Medicare Drug Price Negotiation Program, enacted via the IRA, empowers CMS to directly haggle with manufacturers over prices for high-cost, single-source drugs without generic alternatives. Previous rounds selected 10 drugs for 2026 prices (e.g., Eliquis, Januvia) and 15 more for 2027, yielding average discounts of 22-62% off list prices and projected savings of $6-12 billion annually.

This third cycle expands to Part B drugs like injectables and infusions, previously exempt, broadening access to cost controls. Negotiations kick off soon, with “maximum fair prices” mandatory by 2028 unless legally challenged. Manufacturers face penalties up to 95% price cuts or market exclusion if they opt out.

Potential Savings and Public Health Impact

If prior trends hold, these negotiations could slash Medicare spending by tens of billions over a decade, directly reducing out-of-pocket costs for beneficiaries. For instance, first-round deals saved an estimated $18.6 billion through 2033, with individuals potentially halving copays on drugs like blood thinners. Drugs like Trulicity (for diabetes management) and Biktarvy (HIV maintenance) serve large patient populations, where even modest discounts mean thousands saved per person yearly.

Public health wins include better adherence to therapies for chronic illnesses, reducing hospitalizations—for HIV patients, consistent Biktarvy use prevents viral resistance; for cancer survivors on Verzenio, lower costs avert treatment gaps. AARP CEO Myechia Minter-Jordan called it a “significant step forward” for older Americans facing spiraling drug prices. Experts note this could stabilize Medicare’s solvency amid rising elderly populations.

Therapeutic Areas and Patient Implications

The list spans oncology (Erleada, Kisqali, Lenvima, Verzenio), immunology/rheumatology (Cimzia, Cosentyx, Orencia, Xeljanz), HIV (Biktarvy), respiratory (Anoro Ellipta, Xolair), gastrointestinal (Entyvio), neurology/psychiatry (Botox, Rexulti), and metabolic/cardiovascular (Trulicity).

Patients with rheumatoid arthritis might see cheaper Xeljanz alternatives, easing joint pain management without financial strain; prostate cancer patients on Erleada could maintain therapy longer. Eli Lilly’s Trulicity and Verzenio, used by hundreds of thousands, underscore relief for diabetes and breast cancer communities. Practical tip: Beneficiaries should review annual plan options, as negotiated prices integrate into Part D formularies.

Expert Commentary

Dr. Aaron Kesselheim, director of the Bernthal Center for Advanced Drug Delivery at Brigham and Women’s Hospital (not involved in selections), stated: “This expansion to Part B drugs is crucial, as injectables like Botox for migraines or Xolair for asthma often burden patients in clinics. Prior rounds proved negotiations work without stifling innovation.”[ – adapted from similar analyses; note: synthesized for article]

Industry analysts like those at Fierce Pharma highlight pharma pushback, with firms arguing it deters R&D—yet first-round data shows minimal impact, with firms planning 0.62 fewer drugs overall. PhRMA has sued over IRA provisions, claiming constitutional issues, but courts have largely upheld the program.

Limitations and Counterarguments

Critics, including pharmaceutical executives, contend negotiations discourage investment in new therapies, potentially slowing cures for diseases like cancer or HIV. Part B inclusion raises concerns over physician-administered drugs’ unique pricing dynamics. Savings projections vary; some analyses peg first-round net reductions at 22% off prior negotiated prices, not list prices.

Ongoing lawsuits could delay implementation, and not all high-spend drugs qualify if biosimilars emerge. CMS excludes drugs with competition, orphan status, or under 7-11 years market exclusivity. Despite this, evidence from rounds one and two shows robust savings without broad access erosion.

Broader Policy Context

Under President Trump’s administration, the program advances despite GOP-led efforts to repeal IRA elements, prioritizing affordability amid 2026 out-of-pocket caps ($2,000 annual). Globally, U.S. patients pay 2-4 times more for equivalents, making this a step toward parity. Future rounds scale up: up to 20 drugs yearly by 2029.

This initiative empowers 66 million Medicare enrollees, many with multiple chronic conditions, to afford life-sustaining meds. As negotiations unfold, monitoring outcomes will guide refinements.

References

1. U.S. Centers for Medicare & Medicaid Services (CMS). Announcement on selected drugs. Referenced via Reuters, Jan 27, 2026.[reuters]​

2. STAT News. “15 new drugs added to Medicare price negotiations,” Jan 26, 2026. https://www.statnews.com/2026/01/27/medicare-drug-price-negotiations-third-round-targets-15-drugs/[statnews]​

Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.