This is general educational information, not a plan quote, coverage determination, medical recommendation, or promise of eligibility or savings. Facts were checked against the official sources listed below and are current as of August 14, 2026.
Which drugs are in the 2027 group?
CMS selected 15 high-expenditure, single-source drugs covered under Medicare Part D for the second negotiation cycle. The following names are reproduced from the official CMS fact sheet; combination entries represent one selected drug for negotiation purposes.
- Ozempic; Rybelsus; Wegovy
- Trelegy Ellipta
- Xtandi
- Pomalyst
- Ofev
- Ibrance
- Linzess
- Calquence
- Austedo; Austedo XR
- Breo Ellipta
- Xifaxan
- Vraylar
- Tradjenta
- Janumet; Janumet XR
- Otezla; Otezla XR
When the negotiated prices begin
The negotiated maximum fair prices for this group are scheduled to take effect January 1, 2027. CMS says Medicare prescription drug plans must include selected drugs with an agreed negotiated price on their formularies, and CMS will review formularies for practices that could undermine access.
That formulary requirement does not mean every person will use one of these drugs or have the same pharmacy cost. Coverage rules, dosage, quantity, pharmacy, coverage stage, and eligibility for assistance can affect what an enrollee pays.
Why a negotiated price is not your personal copay
The negotiated price is the price CMS and the participating manufacturer agreed to make available under the program. An enrollee’s out-of-pocket amount is determined through the Part D benefit and the person’s actual coverage circumstances.
Avoid comparing the negotiated price directly with an old list price and assuming the difference will appear dollar-for-dollar at the pharmacy counter. CMS publishes program-level estimates, but individual savings are not guaranteed.
Never stop, start, or change a prescription because of an insurance article. Discuss treatment with the prescribing clinician and verify coverage with the plan or Medicare.
Questions to ask if one of these drugs is on your list
When 2027 plan information is available, verify the exact drug, dosage form, strength, and quantity. Then confirm the formulary tier, pharmacy network, prior authorization, step therapy, quantity limits, deductible treatment, and expected annual cost.
- Is my exact prescription on the official 2027 formulary?
- Does it require prior authorization, step therapy, or a quantity limit?
- Are there preferred pharmacies for this prescription?
- How will this cost count toward my 2027 Part D out-of-pocket threshold?
- Do I qualify for Extra Help or another assistance program?
Primary sources
Official references
- Negotiated Prices for Initial Price Applicability Year 2027CMS
- Selected Drugs and Negotiated PricesCMS
- How do drug plans work?Medicare.gov
CMS and Medicare guidance can change. Verify the current official document before relying on a date, amount, eligibility rule, or process.
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