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Biden administration finalizes new prescription drug prices for Medicare enrollees

The new prices go into effect in 2026 and represent discounts ranging from 38% to 79%.
Medicare Health Insurance
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The White House announced Thursday it has reached an agreement with drug manufacturers as part of the Biden administration's effort to negotiate Medicare prescription drug prices.

Earlier this year, the Centers for Medicare & Medicaid Services notified drug companies of its proposed prices for 10 popular medications. Companies could either accept the government's proposed prices or counteroffer. Instead, the companies sued saying the process was unconstitutional.

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After a judge rejected the drugmakers' claims, the Centers for Medicare & Medicaid Services and drugmakers exchanged offers throughout the spring and summer.

The negotiated prices will become effective on Jan. 1, 2026.

The ability to allow Medicare to negotiate drug prices was included in the Inflation Reduction Act passed by Congress in 2022. The act set a $2,000 price cap on out-of-pocket drug expenses for Medicare Part D enrollees.

The 10 medications will now have the following costs for a 30-day supply:

  • Eliquis (prevention and treatment of blood clots): $231
  • Jardiance (diabetes; heart failure): $197
  • Xarelto (prevention and treatment of blood clots; reduction of risk for patients with coronary or peripheral artery disease): $197
  • Januvia (diabetes): $113
  • Farxiga (diabetes; heart failure; chronic kidney disease): $178
  • Entresto (heart failure): $295
  • Enbrel (rheumatoid arthritis; psoriasis; psoriasis arthritis): $2,355
  • Imbruvica (blood cancers): $9,319
  • Stelara (psoriasis; psoriatic arthritis; Crohn's disease; diabetes): $4,695
  • Fiasp (diabetes): $119

The new prices represent discounts ranging from 38% to 79%.
The White House says that these price negotiations will lead to Medicare saving $6 billion in the first year, while Americans will save another $1.5 billion in out-of-pocket costs.

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"When these lower prices go into effect, people on Medicare will save $1.5 billion in out-of-pocket costs for their prescription drugs and Medicare will save $6 billion in the first year alone," President Joe Biden said. "It’s a relief for the millions of seniors that take these drugs to treat everything from heart failure, blood clots, diabetes, arthritis, Crohn’s disease, and more – and it’s a relief for American taxpayers."

If Drugmakers did not participate in negotiations, they would have been required to withdraw their drugs from the Medicare program or pay an excise tax of at least 65% of their U.S. sales.

Drugmakers initially objected to the law as they filed lawsuits against the Biden administration in hopes of stopping the negotiations.

With this round of negotiations done, the government will next negotiate prices for 15 additional drugs in 2025, 15 more in 2026 and 20 in 2027. All told, Medicare is expected to negotiate pricing on 60 drugs over the next four years, with new prices going into effect by 2029.