Medicare Drug Price Negotiation Reaches Part B: The 2028 Drug List, the November 30 Deadline, and What It Could Mean for You
Medicare’s third round of drug price negotiation is wrapping up this fall, and it’s the first to include Part B drugs, the ones you get in a doctor’s office or infusion center. Fifteen drugs are on the list, including Botox, Entyvio, Orencia, Xolair, Trulicity and Biktarvy, plus a renegotiation of the diabetes pill Tradjenta. CMS has until November 30, 2026 to publish any agreed prices, and they won’t take effect until January 1, 2028.
That means nothing changes for your 2027 coverage because of this round. The prices you’ll see during this fall’s Open Enrollment come from the earlier rounds. I’ll explain where each round stands, who uses these 15 drugs, and what the Part B change could mean for your 20% coinsurance once the prices arrive.
Where each round stands
| Round | Drugs | Medicare part | Prices take effect | Status (Oct 13, 2026) |
|---|---|---|---|---|
| First | 10 | Part D | January 1, 2026 | In effect now |
| Second | 15 (including Ozempic, Wegovy) | Part D | January 1, 2027 | Prices published; start in January |
| Third | 15 + Tradjenta renegotiation | Part B and Part D | January 1, 2028 | Negotiations end Nov. 1; prices due by Nov. 30, 2026 |
For the second round’s 15 drugs and their new prices, see my 2027 Medicare changes guide. CMS estimated those prices would save Part D enrollees about $685 million in out-of-pocket costs in 2027 (CMS fact sheet).
The 15 drugs in the third round
CMS announced the list on January 27, 2026. Between November 2024 and October 2025, about 1.8 million people with Medicare used these drugs, and they accounted for about $27 billion, or 6% of Part B and Part D drug spending (CMS selected drug fact sheet).
| Drug | Commonly used for | Medicare enrollees who used it |
|---|---|---|
| Trulicity | Type 2 diabetes | 617,000 |
| Botox | Chronic migraine, overactive bladder, spasticity | 390,000 |
| Anoro Ellipta | COPD | 281,000 |
| Rexulti | Depression, schizophrenia, agitation with Alzheimer’s dementia | 119,000 |
| Biktarvy | HIV | 101,000 |
| Orencia | Rheumatoid and psoriatic arthritis | 72,000 |
| Cosentyx | Psoriasis, psoriatic arthritis | 40,000 |
| Xolair | Asthma, chronic hives | 40,000 |
| Cimzia | Crohn’s, psoriasis, arthritis | 38,000 |
| Entyvio | Crohn’s disease, ulcerative colitis | 37,000 |
| Xeljanz | Arthritis, ulcerative colitis | 22,000 |
| Erleada | Prostate cancer | 19,000 |
| Kisqali | Breast cancer | 17,000 |
| Verzenio | Breast cancer | 15,000 |
| Lenvima | Thyroid, liver, kidney and endometrial cancer | 10,000 |
Tradjenta was negotiated in the second round and was picked for the program’s first renegotiation. Its 2027 price still starts in January; any new price would apply from 2028.
What the Part B change could mean for you
Part B covers drugs you usually don’t pick up at a pharmacy, such as infusions and injections given by a doctor or clinic. In Original Medicare, you typically pay 20% coinsurance of the Medicare-approved amount after the Part B deductible.
Starting in 2028, Medicare’s Part B payment limit for a drug with a negotiated price is 106% of that price (CMS Part B payment limit overview). If a lower price is reached, the 20% you owe should be based on a smaller number. How much that helps depends on your coverage:
- Original Medicare with no supplement: the most direct benefit, since you pay the 20% yourself.
- Medigap (for example, Plan G): your plan already pays most or all of the coinsurance, so the savings mostly go to Medicare and the plan.
- Medicare Advantage: your plan sets its own cost sharing for Part B drugs, so check its Evidence of Coverage.
For the Part D drugs on the list, the effect works like earlier rounds. If you pay coinsurance (a percentage) or are still in your deductible, a lower price usually means a lower bill. If you pay a flat copay, you may not see a change at the counter. Either way, Part D out-of-pocket costs are capped at $2,400 in 2027; my Part D 2027 guide explains how the cap works.
What happens between now and 2028
These dates come from CMS’s published timeline:
- October 31, 2026: deadline for drug companies to accept or reject CMS’s final offers.
- November 1, 2026: negotiation period ends.
- November 30, 2026: deadline for CMS to publish any agreed prices.
- March 1, 2027: deadline for CMS to publish an explanation of the prices.
- January 1, 2028: prices take effect.
I’ll update this page when CMS publishes the results. Until then, any article quoting “new prices” for Botox or Entyvio is guessing.
What to do this Open Enrollment
Open Enrollment runs October 15 to December 7. This round doesn’t change 2027 prices, so focus on what does:
- Enter your exact drugs and doses in Medicare Plan Finder, which shows each plan’s 2027 cost for them.
- Check whether your plan covers Ozempic or Wegovy for your condition. If you’re looking at a GLP-1 for weight, the separate Medicare GLP-1 Bridge offers eligible Part D enrollees certain GLP-1 drugs for a $50 copay through December 31, 2027. That copay doesn’t count toward your $2,400 cap.
- If your costs are high early in the year, the Medicare Prescription Payment Plan can spread them into monthly bills.
- If your income is limited, check whether you qualify for Extra Help.
The honest pros and cons
| What could help | What to keep in mind |
|---|---|
| First time Part B drugs like Botox and Entyvio are negotiated | No new prices until January 1, 2028 |
| Lower prices can shrink 20% coinsurance in Original Medicare | Medigap holders may see little direct savings |
| Plans must include negotiated drugs on their formularies | Flat Part D copays may not change |
| Prices rise only with inflation (CPI-U) once set | Drug company participation is voluntary, so results aren’t guaranteed |
Common questions
Which drugs are in Medicare’s 2028 price negotiation?
Trulicity, Biktarvy, Orencia, Cosentyx, Erleada, Kisqali, Entyvio, Verzenio, Botox, Lenvima, Xolair, Rexulti, Xeljanz, Anoro Ellipta and Cimzia, plus a renegotiation of Tradjenta.
When will the new Part B drug prices be announced?
CMS must publish any agreed prices from the third round by November 30, 2026. They take effect January 1, 2028.
Will Medicare drug price negotiation lower my costs in 2027?
The third round won’t. The second round’s 15 Part D drug prices, including Ozempic and Wegovy, start January 1, 2027. Your savings depend on your plan’s copay or coinsurance.
Does drug price negotiation lower my Part B coinsurance?
It can. Part B payment for a negotiated drug is based on the negotiated price, so the 20% coinsurance in Original Medicare should be lower once 2028 prices start.
Is Botox covered by Medicare?
Medicare covers Botox for medical uses like chronic migraine, overactive bladder and spasticity when medically necessary. It doesn’t cover cosmetic use, and negotiation doesn’t change that.
Written by Khasim Basha Shaik. I research and compare Medicare plans and rules for readers using CMS and Medicare.gov sources. I’m not a licensed insurance agent, and this isn’t personal advice. Last reviewed October 13, 2026.
