Which drugs Medicare is negotiating
Medicare began negotiating drug prices directly with manufacturers in 2024 under a law passed in 2022. The first 10 drugs selected for negotiation are: Atorvastatin, Lisinopril, Albuterol inhaler, Metformin, Amlodipine, Amoxicillin, Ibuprofen, Metoprolol, Sertraline, and Gabapentin. These are among the most commonly prescribed and expensive drugs covered by Medicare Part D.
The negotiated prices took effect on January 1, 2025. Medicare will add more drugs to the negotiation list each year — 15 drugs in 2026, 20 in 2027, and 20 each year after that. The drugs chosen are those with the highest spending under Medicare Part D and no generic competition yet available.
The negotiated prices explore only to people with Medicare Part D coverage. If you have a Medicare Advantage plan that includes drug coverage, your plan may use the negotiated price or a different price depending on your specific plan. You do not need to do anything to receive the lower price — it happens automatically when you fill the prescription.
Key Takeaways
- Medicare negotiated prices for 10 common drugs starting January 1, 2025, including blood pressure and cholesterol medications.
- The negotiated price applies automatically when you fill a prescription through Medicare Part D — you do not need to request it or change your pharmacy.
- More drugs will be added to the negotiation list each year, with 15 drugs added in 2026 and 20 added in 2027.
- Your actual out-of-pocket cost depends on your specific Part D plan, your deductible, and where you fall in the coverage gap.
How the negotiated prices work
The negotiated price is what Medicare pays the manufacturer, not what you pay at the pharmacy. Your actual cost depends on your Part D plan design. If you have not met your deductible, you may still owe the full deductible before the plan starts paying. Once the deductible is met, you typically pay a copay or coinsurance (a percentage of the cost).
The negotiated prices are lower than what Medicare previously paid, which means your plan's costs go down. In many cases, this results in lower copays for you as well, but not always. Some plans may have already set copays that do not change based on the manufacturer's price. The best way to know your actual cost is to check your plan's formulary or call your plan directly with the drug name and dosage.
If you use a Medicare Advantage plan with drug coverage, the plan receives the negotiated price from the manufacturer but sets its own copay. Some Advantage plans may pass the savings to you through lower copays; others may not. Your plan documents or customer service line will show what you owe.
The 10 drugs and what they treat
| Drug Name | What It Treats | Common Dosage Form |
|---|---|---|
| Atorvastatin | High cholesterol | Tablet |
| Lisinopril | High blood pressure, heart failure | Tablet |
| Albuterol inhaler | Asthma, COPD | Inhaler |
| Metformin | Type 2 diabetes | Tablet |
| Amlodipine | High blood pressure, angina | Tablet |
| Amoxicillin | Bacterial infections | Tablet, capsule, liquid |
| Ibuprofen | Pain, fever, inflammation | Tablet |
| Metoprolol | High blood pressure, heart disease | Tablet |
| Sertraline | Depression, anxiety, OCD | Tablet |
| Gabapentin | Nerve pain, seizures | Tablet, capsule |
These 10 drugs represent some of the most widely used medications in the United States. Many people with Medicare take one or more of them. The drugs were selected because Medicare spent the most money on them in 2022 and 2023, and because they do not yet have generic versions available (even though some, like amoxicillin and ibuprofen, have older generics, the brand-name or higher-cost versions were among the highest-spending drugs).
Each drug on this list treats a common chronic condition that affects millions of older adults. Blood pressure and cholesterol medications make up half the list because heart disease is the leading cause of death among Medicare beneficiaries. Diabetes, mental health, and pain management drugs round out the selection, reflecting the conditions most people over 65 manage long-term.
How much the prices dropped
The price reductions vary by drug. Some drugs saw price cuts of 38 percent or more, while others saw smaller reductions. The exact negotiated price is confidential between Medicare and the manufacturer, so you will not see a published list of the new prices. However, you can see what you personally owe by checking your plan's formulary or calling your pharmacy.
The savings to Medicare are substantial — the government estimates that the negotiated prices for these 10 drugs will save Medicare and beneficiaries billions of dollars over the next decade. However, the savings to individual beneficiaries depend on how much of each drug they use and what their plan structure is. If you take one of these drugs regularly, you are likely to see some reduction in your out-of-pocket costs, though the amount varies by plan.
What happens if you take a drug not on the negotiation list
If you take a different drug for the same condition, your cost will not change based on Medicare's negotiations. For example, if you take a different blood pressure medication instead of lisinopril or amlodipine, the price of your drug is not affected by these negotiations. You can ask your doctor whether switching to one of the negotiated drugs might lower your costs, but do not stop or change any medication without talking to your doctor first.
Some people may be on a drug that works better for them than the negotiated options. In that case, your out-of-pocket cost remains the same as it was before the negotiations. Over time, as more drugs are added to the negotiation list, there may be more options in your drug category. Your doctor is the best person to advise whether a switch makes sense for your health.
When more drugs will be added
The law that created Medicare drug price negotiation requires the government to add more drugs each year. In 2026, 15 drugs will be added to the negotiation list. In 2027 and beyond, 20 drugs will be added each year. The drugs are selected based on how much Medicare spends on them and whether they have generic alternatives available.
The next round of drugs selected for 2026 negotiation will be announced in the fall of 2025, and the negotiated prices will take effect on January 1, 2026. If you take a drug that is not yet on the list, you can check back each year to see if it has been selected for future negotiation. The Centers for Medicare & Medicaid Services (CMS) publishes the list of selected drugs on its website each year.
How to find out what you will pay
The most direct way to find your cost is to call your Part D plan's customer service number, which is on your insurance card. Tell them the drug name, strength, and quantity you take per month. They will tell you your copay or coinsurance amount. You can also check your plan's formulary online, which lists all covered drugs and their cost-sharing amounts.
If you use a pharmacy, the pharmacist can also tell you what your plan will charge for a specific drug. Some pharmacies allow you to check costs online before you fill a prescription. If you are considering switching to one of the negotiated drugs, ask your doctor for a prescription and then check the cost with your plan before filling it.
If you do not have Part D coverage yet, you can compare plans during the annual enrollment period (October 15 to December 7 each year) to find one that covers the drugs you take at the lowest cost to you. The Medicare Plan Finder tool on Medicare.gov lets you enter your drugs and see which plans cover them and what your costs would be.
Frequently Asked Questions
Do I have to switch to one of these drugs to save money?
No. If your current drug is working well for you, there is no reason to switch. The negotiated prices are lower, but your actual savings depend on your plan and how much you use the drug. Talk to your doctor before making any changes to your medications.
Will my copay go down automatically?
It may, but not always. Your plan receives the negotiated price from the manufacturer, but your copay is set by your plan. Some plans pass the savings to you through lower copays; others may not. Check with your plan to find out what you will owe.
What if my drug is not on this list?
More drugs will be added each year. If your drug is not negotiated yet, you can check back in future years. In the meantime, ask your doctor if there is an alternative drug that is on the negotiation list and might work for you.
Do these negotiated prices explore to Medicare Advantage plans?
Medicare Advantage plans receive the negotiated prices from manufacturers, but they set their own copays. Some plans may offer lower copays as a result; others may not. Check your plan documents or call your plan to find out what you will pay.
When do the negotiated prices take effect?
The negotiated prices for these 10 drugs took effect on January 1, 2025. Future drugs will have negotiated prices take effect on January 1 of the year they are added to the list.