What to Know About New Medicare Prescription Costs

There’s good news on Medicare prescription costs. The federal government announced on Aug. 15, 2024, that it had negotiated down the prices of 10 common prescription drugs used by Medicare recipients.

These 10 drugs are among most expensive and frequently dispensed drugs in the Medicare program, says the U.S. Department of Health and Human Services . They’re used to treat heart disease, diabetes, cancer, and other conditions. The new prices apply to enrollees in the Medicare Part D prescription drug coverage and take effect on Jan. 1, 2026.

To achieve the prices cuts, the government negotiated with major pharmaceutical companies Merck & Co, Novo Nordisk, AstraZeneca, Amgen, Johnson & Johnson, and others.

Medicare prescription cost cuts

Affected drugs and the conditions they’re used to treat are:

• Januvia – diabetes
• NovoLog , Fiasp (insulin aspart) – diabetes
• Farxiga – diabetes
• Jardiance – diabetes
• Enbrel – autoimmune conditions
• Stelara – proriasis and arthritis
• Xarelto – blood clotting
• Eliquis – blood clotting
• Entresto – heart failure
• Imbruvica – cancer

Although some critics claim that the discounts will hurt pharmaceutical companies, several companies stated that they didn’t expect this to have a significant impact on their business.

Vanderbilt University professor Stacie Dusetzina said while the new discounts and savings were encouraging, they were not so aggressive that they would cause concern for the industry, Reuters news service reported . “It suggests to me that companies are still going to be able to make profits have incentives to innovate,” she said.

The new prescription drug price negotiations are a result of the Inflation Reduction Act, signed into law in 2022. The IRA enabled Medicare to negotiate prices for some of the most costly drugs that the program covers for 66 million people.

Other Medicare benefits from the Inflation Reduction Act

Beginning Jan. 1, 2023, the IRA put a cap on the price of insulin for people on Medicare. Medicare.gov explained, “Plans can’t charge you more than $35 for a one-month supply of each Medicare Part D-covered insulin you take, and can’t charge you a deductible for insulin.”

Related: Good news on insulin for those on Medicare

Beginning in February 2025, the Centers for Medicare & Medicaid Services will select up to 15 more drugs covered under Part D for negotiation for 2027. The following year, CMS will select up to 15 more drugs covered by Part B or Part D for 2028, then up to 20 more Part B or Part D drugs each year after that.

Also next year , all Medicare Part D enrollees will benefit from a $2,000 out-of-pocket cap on their prescription drug costs, further making prescription drugs more affordable for seniors and people with disabilities.

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