7 Medicare Drug Negotiation Changes That Could Slash Your Prescription Bills—Find Out If Your Medications Are Affected
In a historic shift set to redefine how prescription medications are priced in the United States, Medicare has begun flexing its long-sought authority to negotiate drug prices directly with pharmaceutical companies.
This policy, rooted in the Inflation Reduction Act of 2022, promises sweeping changes to how older Americans pay for life-saving medications—and how the federal government manages ballooning healthcare costs.
After decades of resistance and lobbying from Big Pharma, the Centers for Medicare & Medicaid Services (CMS) is now equipped to go head-to-head with drugmakers, aiming to drive down the cost of some of the most expensive and widely used drugs in the country.
If you’re on Medicare—or heading toward eligibility—these changes could mean substantial savings in your monthly prescription bills.
Here are seven critical changes taking place under the new Medicare drug price negotiation rules, and how they could affect your health, your wallet, and your peace of mind.
1. Expansion of the Negotiated Drug List
The foundation of the new program is Medicare’s ability to target and negotiate prices on high-cost medications that account for a significant share of Medicare spending.
The first list of 10 drugs targeted in 2023 included well-known and widely prescribed treatments for diabetes, heart failure, and cancer. In 2025, CMS has added 15 more drugs to the negotiation roster.
Notable additions include Ozempic, Wegovy, and Januvia, all commonly used to manage type 2 diabetes and weight-related conditions. These drugs alone cost Medicare billions annually and often burden patients with monthly out-of-pocket costs in the hundreds.
By focusing on drugs that have no generic competition and are disproportionately expensive, CMS is working to maximize impact. This list will expand annually, with 20 additional drugs expected to be added in each successive year starting in 2026.
If your medication isn’t on the current list, that doesn’t mean it won’t be in the near future.
2. Substantial Savings for Patients and the Medicare System
One of the most anticipated outcomes of the negotiation program is direct cost savings for patients. CMS estimates that Medicare enrollees will collectively save $1.5 billion in out-of-pocket costs in the first year alone. And it’s not just patients—U.S. taxpayers stand to save over $6 billion due to lower Medicare drug expenditures.
For example, Januvia, a popular Merck drug for type 2 diabetes, currently costs about $527 per 30-day supply. With negotiations, that price is expected to fall to roughly $113—a dramatic drop for seniors living on fixed incomes.
Critics have long argued that Americans pay far more for the same medications than residents of other countries. With this program, the U.S. is taking a major step toward narrowing that gap, while preserving access to necessary drugs.
3. Inclusion of Medicare Part B Drugs
Previously, drug pricing reforms focused largely on Medicare Part D, which covers prescriptions filled at retail pharmacies. Now, for the first time, Medicare’s negotiation program will include select Part B drugs—those administered in hospital or clinical settings, often via injection or infusion.
This change is especially important for patients battling chronic or severe illnesses, such as cancer or rheumatoid arthritis, where injectable biologics and immunotherapies can cost thousands each month.
By including these drugs, Medicare broadens the impact of the program considerably. Beneficiaries who previously faced massive cost-sharing responsibilities under Part B may soon see meaningful relief.
4. Closing Loopholes in Drug Reformulations
In the past, pharmaceutical companies would often reformulate existing drugs—changing the delivery mechanism or combining them with another ingredient—to reset the regulatory clock and delay generic competition or price review.
CMS’s updated negotiation guidelines now close this loophole. Reformulated drugs will no longer be exempt from negotiation simply because of minor structural or chemical tweaks. This means that drugs long available but slightly altered in form will still be subject to price negotiation.
For example, a popular asthma inhaler reformulated from a metered-dose to a dry-powder inhaler will not escape review, even if the delivery method changes. This prevents companies from gaming the system to extend profit margins indefinitely at the expense of patients.