After hinting¹ that an announcement was forthcoming, the Centers for Medicare & Medicaid Services (CMS) did ultimately unveil the negotiated prices for 15 of the most expensive prescription meds under Medicare—a program that covers more than 67 million people age 65 and over, along with those with disabilities—just in time for Thanksgiving.

Overall, noted the CMS, there is a net savings of 44%, or $12 billion, when compared Medicare’s 2024 net spending on these specific drugs.^2,3 As stated in the Inflation Reduction Act (IRA)—which provides Medicare with the right to directly negotiate with drug companies as a way to improve access to various brand name Part B and D meds—these savings that represent the second round of negotiations will take effect Jan. 1, 2027, and will reflect the maximum fair price (MFP) of each of these drugs.

As for the first round of 10 negotiated prices (announced back in August 2024), those will go into effect Jan. 1, 2026.

“President Trump directed us to stop at nothing to lower health care costs for the American people,” said Health and Human Services Secretary Robert F. Kennedy, Jr. “As we work to Make America Healthy Again, we will use every tool at our disposal to deliver affordable health care to seniors.”

GLP-1 weight loss and diabetes drugs headline list of price reductions

One drug on everyone’s radar was Novo Nordisk’s Ozempic and Wegovy, both of which will be receiving a 71% discount from 2024’s list price. This represents a negotiation monthly cost of $274.

Meanwhile, Novo Nordisk and Eli Lilly are also working on oral GLP-1 medications, which will reportedly be available on the government-run DTC platform, TrumpRx, for $145-a-month. These medications will also be available for the same price through Medicare and Medicaid.¹

How CMS sets prices under the IRA

Medicare must weigh multiple factors when setting prices under the IRA, including manufacturer-provided data and the availability of alternative therapies. However, it’s important to note the law does not require Medicare to evaluate international drug prices as part of this process.

Analysts compared the prices against two key benchmarks: Medicare's recent net prices (after factoring in confidential rebates and discounts) and the prices negotiated by other high-income countries, a policy also known as most-favored nation (MFN) pricing.

“This year’s results stand in stark contrast to last year’s,” commented CMS Administrator Mehmet Oz, MD. “Using the same process with a bolder direction, we have achieved substantially better outcomes for taxpayers and seniors in the Medicare Part D program—not the modest or even counterproductive ‘deals’ we saw before."

Next February, Medicare will undergo the third round of drug price negotiations, which are anticipated to feature 15 more Rx and hospital-administered drugs.

CMS rolling out new Medicaid model to reduce costs and boost access to affordable care

In another effort to cut Medicaid drug costs and expand access to affordable meds, CMS will be debuting an Innovation Center initiative next year⁴ with three goals in mind:

1. Decrease Medicaid Rx drug spending
2. Boost health outcomes by opening up move avenues for medication access
3. Bolster the Medicaid program as a whole

Known as the GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) Model, the individual states whose Medicaid programs elect to join the pilot program will reportedly be able to buy meds at fairer, competitive prices that closely align to what is being paid in other nations.

According to CMS data, the total gross Medicaid spending on prescription drugs was over $100 billion last year, representing a $10 billion increase over 2022 numbers.

References

1. Saraceno N. Medicare Set to Unveil Prices for 15 High-Cost Drugs. Pharmaceutical Commerce. November 25, 2025. Accessed November 26, 2025. https://www.pharmaceuticalcommerce.com/view/medicare-set-to-unveil-prices-15-high-cost-drugs

2. CMS Delivers Savings for Seniors on 15 Major Drugs for Cancer and Chronic Disease. CMS.gov. November 25, 2025. Accessed November 26, 2025. https://www.cms.gov/newsroom/press-releases/cms-delivers-savings-seniors-15-major-drugs-cancer-chronic-disease

3. Eaton ES. CMS Reveals Pricing Discounts for 15 Drugs Under Second Round of IRA Negotiations. FirstWord Pharma. November 25, 2025. Accessed November 26, 2025. https://firstwordpharma.com/story/6693070

4. Saraceno N. CMS Unveils Initiative to Cut Medicaid Drug Costs and Expand Access to Affordable Medications. Pharmaceutical Commerce. November 10, 2025. Accessed November 25, 2025. https://www.pharmaceuticalcommerce.com/view/cms-unveils-initiative-cut-medicaid-drug-costs-expand-access-to-affordable-medications