The 15 drugs getting Medicare price cuts in 2027, from Ozempic to Trelegy

From the launch of Part D in 2006 until 2022, federal law barred Medicare from negotiating drug prices directly with manufacturers. That ban is gone. On January 1, 2027, Medicare negotiated drug prices for a second group of 15 medicines take effect, including the semaglutide drugs Ozempic, Wegovy and Rybelsus. Measured against 2024 list prices, the new prices run from 38% to 85% lower.

The Centers for Medicare & Medicaid Services (CMS) announced the prices on November 25, 2025, under the Medicare Drug Price Negotiation Program created by the Inflation Reduction Act of 2022. The law labels them maximum fair prices. Drugmakers must honor them for people with Medicare drug coverage and for the pharmacies that fill their prescriptions.

MedicareGuide.com’s breakdown of the 2027 negotiated prices pulls together the CMS figures. About 5.3 million of the 53 million people enrolled in Part D used at least one of the 15 drugs in 2024. Had the new prices applied that year, CMS estimates Medicare would have spent about $12 billion less on them after rebates, a 44% saving. A second CMS calculation, which also accounts for an older manufacturer discount program, puts the figure at about $8.5 billion, or 36%. For patients, CMS projects about $685 million in lower out-of-pocket costs in 2027 under the standard Part D benefit.

The list reaches well beyond GLP-1 drugs. It includes two GSK inhalers for asthma and chronic obstructive pulmonary disease (COPD), two older diabetes pills, four cancer drugs, and treatments for lung scarring, psoriasis, schizophrenia, constipation, a liver-related brain disorder and involuntary movement conditions.

A lower Medicare price does not guarantee a lower bill at the pharmacy counter. People who pay coinsurance, or who are still working through their deductible, stand to gain the most. Those with flat copays may see no change. Medicare open enrollment runs through December 7, 2026, which is the window to check how a 2027 plan handles each drug.

Every price below is for a 30-day supply. List prices are 2024 wholesale figures before rebates, as reported by CMS. The slides follow the order of the CMS list.

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Medicare’s negotiated price for semaglutide — sold as Ozempic, Wegovy and Rybelsus — is $274 for a 30-day supply starting January 1, 2027. That is 71% below the 2024 list price of $959, and semaglutide is the biggest drug in the second round by Medicare spending.

All three brands come from Danish drugmaker Novo Nordisk and share the same active ingredient. Semaglutide mimics GLP-1, a gut hormone that prompts insulin release after meals, slows digestion and curbs appetite. Ozempic, a once-weekly injection, won FDA approval for type 2 diabetes in 2017. Rybelsus followed in 2019 as the first GLP-1 drug in pill form. Wegovy, a higher-dose injection, was approved for chronic weight management in 2021.

According to CMS, about 2.3 million Part D enrollees used one of the three in 2024, and Part D spent about $15.2 billion on them before rebates. The negotiated price covers every form and strength. CMS lists $276.78 for a single Ozempic 4 mg/3 mL pen and $385.63 for a box of four Wegovy 2.4 mg pens.

The price cut does not widen coverage. Federal law bars Part D from paying for drugs used for weight loss. Plans can cover Ozempic and Rybelsus for type 2 diabetes. They can cover Wegovy to lower the risk of heart attack and stroke in adults with cardiovascular disease who have obesity or are overweight, a use the FDA approved in 2024.

People who want a GLP-1 drug for weight loss alone have a separate, temporary route. The Medicare GLP-1 Bridge started July 1, 2026, and runs through December 31, 2027. It covers certain forms of Wegovy, Zepbound and Foundayo for a $50 copay per one-month supply. Enrollees must be 18 or older, meet body mass index rules and have a prescription tied to a diet and exercise program. That $50 does not count toward the Part D deductible or out-of-pocket cap, and Extra Help cannot reduce it.

People with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease are not eligible for the Bridge, since their Part D plan may cover GLP-1 drugs for those conditions.

Separately, Novo Nordisk has said it will lower the U.S. list price of all three brands to $675 a month on the same date the negotiated price begins.

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Trelegy Ellipta, GSK’s once-daily inhaler for asthma and COPD, will carry a Medicare negotiated price of $175 for a 30-day supply in 2027. The 2024 list price was $654, so the new price is 73% lower.

Trelegy is a triple-therapy inhaler. Each inhalation delivers three medicines. Fluticasone furoate is an inhaled corticosteroid that calms airway inflammation. Umeclidinium is a long-acting muscarinic antagonist, and vilanterol is a long-acting beta agonist. Those two relax the muscles around the airways through different pathways, keeping them open for a full day. Packing all three into one device means patients take a single inhalation a day instead of juggling two or three separate inhalers.

The FDA approved Trelegy for COPD in 2017 and extended it to asthma in adults in 2020. COPD, an umbrella term that covers emphysema and chronic bronchitis, is most common in older adults and in people with a long history of smoking. That puts many Trelegy users squarely in the Medicare population.

The device itself, Ellipta, is a dry powder inhaler. Patients slide open the cover, which loads a dose, and breathe in deeply. There is no propellant, and no need to time a press on a canister with an inhaled breath.

Trelegy is one of two GSK Ellipta inhalers on the 2027 list. Its sibling, Breo Ellipta, contains two of the same three ingredients.

Because Trelegy is on the negotiated list, every stand-alone Part D plan and every Medicare Advantage plan with drug coverage must include it on its formulary in 2027. That requirement applies to all 15 drugs. Inclusion does not set the patient’s cost, though. Plans still decide which tier Trelegy sits on, whether to charge a copay or coinsurance, and whether to require prior authorization. CMS has said it will review formularies for practices that could limit access to the negotiated drugs.

Anyone using Trelegy can look up its tier on their plan’s 2027 formulary before open enrollment closes on December 7, 2026.

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Xtandi, the prostate cancer drug sold by Astellas and Pfizer $PFE, will cost Medicare $7,004 for a 30-day supply in 2027 under its negotiated price. That is 48% below its 2024 list price of $13,480, a reduction of $6,476 a month.

Xtandi’s generic name is enzalutamide. It is an androgen receptor inhibitor, which means it blocks testosterone and related male hormones from fueling prostate cancer cells. Many prostate tumors depend on those hormones to grow. That dependence is why hormone-blocking treatment has long been a backbone of care for advanced disease.

The FDA first approved Xtandi in 2012 for men whose metastatic prostate cancer had stopped responding to standard hormone therapy, a stage known as castration-resistant prostate cancer. Its approved uses have since expanded to earlier stages of the disease. Enzalutamide was discovered by researchers at the University of California, Los Angeles, before it was developed commercially. Patients take it by mouth once a day.

Prostate cancer risk rises sharply with age, and most diagnoses come in men 65 or older. That makes Medicare a central payer for drugs like Xtandi.

For a drug this expensive, the Part D out-of-pocket cap shapes what patients pay more than the list price does. In 2027 the cap rises to $2,400, up from $2,100 in 2026. The maximum deductible rises to $700, from $615. Once a patient’s out-of-pocket spending on covered drugs reaches the cap, they pay nothing more for covered Part D drugs for the rest of the year.

Someone taking Xtandi is likely to hit that cap whether the monthly price is $13,480 or $7,004. The lower negotiated price may mean the cap arrives somewhat later in the year rather than lowering the patient’s annual total. In that case, most of the savings show up in what the program pays rather than in what the patient pays.

Xtandi is one of four cancer treatments in the second round. The others are Pomalyst, Ibrance and Calquence.

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Pomalyst had the highest list price of any drug in Medicare’s second negotiation round: $21,744 for a 30-day supply in 2024. Its 2027 negotiated price is $8,650, which is 60% lower and $13,094 less per month.

Bristol Myers Squibb $BMY sells Pomalyst, which it gained through its 2019 acquisition of Celgene. The drug’s generic name is pomalidomide. It belongs to a class called immunomodulatory drugs, chemical relatives of thalidomide that also include lenalidomide, sold as Revlimid. These drugs work on several fronts. They help the immune system attack cancer cells, interfere with the blood supply tumors rely on and act directly on malignant cells.

The FDA approved Pomalyst in 2013 for multiple myeloma, a cancer of the plasma cells in bone marrow. It is typically used after patients have already gone through other treatments, including lenalidomide, and is usually paired with the steroid dexamethasone. In 2020 the FDA added a second use: Kaposi sarcoma, a cancer that causes lesions on the skin and in other tissues. Kaposi sarcoma is linked to a herpesvirus and occurs most often in people with weakened immune systems, including people with HIV.

Multiple myeloma is mostly diagnosed in older adults, so many Pomalyst patients are on Medicare.

Pomalyst’s link to thalidomide shapes how it is dispensed. Thalidomide caused severe birth defects when it was given to pregnant women in the late 1950s and early 1960s. As a result, Pomalyst is available only through a restricted distribution program run under FDA safety rules. Prescribers, pharmacies and patients must enroll. Patients who could become pregnant must follow strict contraception and pregnancy-testing requirements.

Even at the negotiated price, a full year of Pomalyst adds up to roughly $103,800, compared with about $261,000 at the 2024 list price. The price that pharmacies receive also changes. Drugmakers must make the negotiated price available to the pharmacies that fill Medicare prescriptions, not only to the plans that pay for them.

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Ofev, Boehringer Ingelheim’s treatment for idiopathic pulmonary fibrosis, will have a 2027 Medicare negotiated price of $6,350 for a 30-day supply. That is half of its 2024 list price of $12,622.

Idiopathic pulmonary fibrosis, or IPF, is a disease in which lung tissue becomes thick, stiff and scarred over time. Idiopathic means the cause is unknown. As scarring builds, the lungs struggle to move oxygen into the blood. Patients develop worsening shortness of breath and a persistent dry cough. IPF is most often diagnosed in people over 60, and it is more common in men and in people with a history of smoking.

Ofev’s generic name is nintedanib. It is a tyrosine kinase inhibitor that blocks several growth-factor signals involved in the scarring process. It does not cure IPF or reverse existing damage. Clinical trials showed it slows the decline in lung function. Patients take it as a capsule twice a day, and diarrhea is its most common side effect.

The FDA approved Ofev for IPF in 2014, on the same day it approved pirfenidone, sold as Esbriet. Before then, no drug was approved for the disease in the U.S. Ofev has since been approved for other scarring lung conditions, including interstitial lung disease tied to systemic sclerosis and chronic fibrosing lung diseases that keep progressing.

Because Ofev is taken continuously and carries a high price, a patient’s cost depends heavily on plan design. Those who pay coinsurance, a percentage of the drug’s cost, see their share shrink when the price falls. Those who pay a flat copay per fill may see no change at all, because the plan sets that dollar amount regardless of the drug’s price.

The negotiated price applies whether a patient’s drug coverage comes from a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage. People with Original Medicare and no drug plan get no benefit from the new price at the pharmacy. For them, open enrollment through December 7, 2026, is the chance to add Part D coverage for 2027.

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Pfizer $PFE’s Ibrance, a breast cancer drug taken by mouth, will have a Medicare negotiated price of $7,871 for a 30-day supply starting in 2027. Its 2024 list price was $15,741, so the new price is 50% lower.

Ibrance’s generic name is palbociclib. When the FDA approved it in 2015, it was the first drug in a class known as CDK4/6 inhibitors. CDK4 and CDK6 are enzymes that help cells move through the cycle of division. Blocking them slows the growth of cancer cells that rely on that pathway. Two later drugs in the same class, Novartis’s Kisqali and Eli Lilly $LLY’s Verzenio, now compete with it.

Ibrance is used for hormone receptor-positive, HER2-negative breast cancer that is advanced or has spread to other parts of the body. That subtype is the most common form of breast cancer. Ibrance is taken alongside hormone therapy, such as an aromatase inhibitor or fulvestrant, rather than on its own. A typical schedule is one dose a day for 21 days, followed by seven days off.

Breast cancer risk rises with age, and the median age at diagnosis in the U.S. is in the early 60s. Many women on long-term treatment for metastatic disease are therefore covered by Medicare.

Ibrance joins a growing group of cancer drugs with Medicare-set prices. The first round, which took effect January 1, 2026, included Imbruvica for blood cancers. The 2027 round adds Ibrance, Xtandi, Pomalyst and Calquence.

Negotiated prices are not frozen. For drugs that stay in the program, CMS adjusts the price each year for inflation. A drug leaves the program once CMS finds that a generic or biosimilar version is on the market, at which point competition is expected to do the work that negotiation did.

Patients on Ibrance who want to estimate their 2027 costs can enter the drug and their pharmacy in Medicare Plan Finder on Medicare.gov. The tool compares estimated yearly costs across the plans available in their area.

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Linzess, a once-daily capsule for chronic constipation, will cost Medicare $136 for a 30-day supply under its 2027 negotiated price. That is 75% below its 2024 list price of $539.

AbbVie and Ironwood Pharmaceuticals market Linzess in the U.S. The FDA approved it in 2012 for two conditions. Chronic idiopathic constipation is long-term constipation with no identifiable cause. Irritable bowel syndrome with constipation, often shortened to IBS-C, combines constipation with recurring abdominal pain. Both are common, and chronic constipation becomes more prevalent with age.

Linzess’s generic name is linaclotide. It works in the gut rather than throughout the body. The drug activates a receptor called guanylate cyclase-C on the lining of the intestine. That increases the flow of fluid into the bowel and speeds the movement of stool. It also appears to dampen pain signals from the gut, which matters for IBS-C patients whose main complaint is often discomfort. Patients take it on an empty stomach at least 30 minutes before the first meal of the day. Diarrhea is the most common side effect.

Linzess is one of two gastrointestinal drugs on the 2027 list. The other, Xifaxan, treats the opposite IBS subtype — IBS with diarrhea — along with a serious liver-related brain condition.

For a moderately priced maintenance drug like Linzess, plan design determines how much of the 75% cut a patient sees. Medicare’s standard Part D benefit charges 25% coinsurance after the deductible. On the new price, 25% of $136 is $34, compared with about $135 on the old list price. Many plans instead charge a flat copay set by tier, and that copay may stay the same.

People in the deductible phase generally pay the full cost of their drugs until they meet it. Some plans have no deductible at all. CMS says eligible patients will not pay more than the negotiated price at the pharmacy counter, so a deductible-phase fill of Linzess in 2027 should cost no more than $136.

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Calquence, AstraZeneca $AZN’s pill for several blood cancers, will have a Medicare negotiated price of $8,600 for a 30-day supply in 2027. That is 40% below its 2024 list price of $14,228, a monthly reduction of $5,628.

Calquence’s generic name is acalabrutinib. It is a BTK inhibitor, a drug that blocks Bruton’s tyrosine kinase. Cancerous B cells, a type of white blood cell, depend on that protein to survive and multiply. Shutting down the signal slows the growth of cancers that arise from those cells.

The FDA approved Calquence in 2017 for mantle cell lymphoma, a relatively uncommon form of non-Hodgkin lymphoma. In 2019 it added chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). CLL and SLL are essentially the same disease, showing up mainly in the blood or mainly in the lymph nodes. CLL is the most common leukemia in adults in Western countries and is diagnosed mostly in older people.

Calquence is a second-generation BTK inhibitor. The first drug in the class, Imbruvica, was among the 10 drugs in Medicare’s first negotiation round. Imbruvica’s negotiated price, in effect since January 1, 2026, is $9,319 for a 30-day supply, against a 2023 list price of $14,934. With Calquence added, two of the main BTK inhibitors now carry Medicare-negotiated prices.

AstraZeneca designed acalabrutinib to bind more selectively to its target than ibrutinib, the active ingredient in Imbruvica. The goal was to reduce side effects tied to off-target activity, such as certain heart rhythm problems.

The 40% cut is among the smaller percentage reductions in the second round. Only Austedo, at 38%, falls by less. Calquence’s negotiated price is also close to Imbruvica’s. The two drugs’ Medicare prices now differ by $719 a month.

Patients who take Calquence can find their plan’s 2027 changes in its Annual Notice of Change. That document shows how the plan’s premium, deductible and drug costs shift for the new year, and it arrives before open enrollment begins.

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Austedo and its extended-release version, Austedo XR, will have a Medicare negotiated price of $4,093 for a 30-day supply in 2027. That is 38% below the 2024 list price of $6,623 — the smallest percentage reduction among the 15 drugs.

Teva Pharmaceuticals makes Austedo, whose generic name is deutetrabenazine. It treats two movement disorders. The first is chorea, the involuntary, jerky movements that are a hallmark of Huntington’s disease, an inherited brain disorder. The second is tardive dyskinesia, marked by repetitive, uncontrolled movements, often of the face, lips and tongue. Tardive dyskinesia can develop after long-term use of antipsychotics and certain other drugs that block dopamine.

Deutetrabenazine is a VMAT2 inhibitor. It reduces the amount of dopamine that nerve cells release, which damps down excess movement. The drug is a modified version of an older medicine, tetrabenazine. Some hydrogen atoms in the molecule are replaced with deuterium, a heavier form of hydrogen. That swap slows how quickly the body breaks the drug down, allowing steadier blood levels and less frequent dosing.

The FDA approved Austedo in 2017 for both uses. Austedo XR, approved in 2023, is taken once a day. The negotiated price covers both versions.

Tardive dyskinesia connects Austedo to another drug on the 2027 list. Vraylar, an antipsychotic used for schizophrenia, bipolar disorder and depression, carries the tardive dyskinesia warning that applies to its whole drug class.

Movement disorders usually require long-term treatment, so the yearly effect of the price adds up. At the negotiated price, a full year of Austedo costs about $49,100, compared with nearly $79,500 at the 2024 list price.

As with every drug on the list, a lower price is not a reason to change treatment on one’s own. Patients considering a switch in medicine or plan should talk with their doctor or pharmacist first.

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Breo Ellipta, GSK’s two-drug maintenance inhaler for asthma and COPD, will carry a Medicare negotiated price of $67 for a 30-day supply in 2027. That is 83% below its 2024 list price of $397.

Breo combines two of the three medicines in Trelegy Ellipta, GSK’s other inhaler on the 2027 list. Fluticasone furoate, an inhaled corticosteroid, reduces inflammation in the airways. Vilanterol, a long-acting beta agonist, relaxes the airway muscles for about 24 hours. Together they serve as a once-daily controller medicine, not a rescue inhaler for sudden attacks. Patients still need a separate fast-acting inhaler, such as albuterol, for that.

The FDA approved Breo Ellipta for COPD in 2013 and for asthma in 2015. GSK developed the combination with its partner Theravance. Like Trelegy, it uses the Ellipta dry powder device, so patients who move from one to the other keep the same inhaler technique.

For patients whose symptoms are not controlled on a two-drug inhaler, doctors may move to a triple-therapy inhaler such as Trelegy. Both now carry negotiated prices, at $67 and $175 respectively.

At $67, Breo has the lowest negotiated price of any drug in the second round. Its 83% cut is the third-deepest, behind Janumet at 85% and Tradjenta at 84%.

Low-cost maintenance drugs like Breo show how premiums shape the overall bill. CMS projects the average stand-alone Part D premium will be about $36 a month in 2027, up from $35.09. A patient comparing plans should add premiums, the deductible and expected drug costs together, rather than looking only at a single drug’s tier. A plan with a slightly higher premium can still cost less over a year if it covers a patient’s full set of drugs on lower tiers.

Free plan-comparison help is available through each state’s State Health Insurance Assistance Program, known as SHIP. SHIP counselors can walk through formularies and costs for the plans available in a given area.

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Xifaxan, an antibiotic used for a serious complication of liver disease and for IBS with diarrhea, will have a Medicare negotiated price of $1,000 for a 30-day supply in 2027. That is 63% below its 2024 list price of $2,696, a monthly drop of $1,696.

Salix Pharmaceuticals, part of Bausch Health, sells Xifaxan. Its generic name is rifaximin. Very little of it is absorbed into the bloodstream, which sets it apart from most antibiotics. It stays largely in the gut, where it acts on intestinal bacteria.

That property makes it useful for hepatic encephalopathy, a decline in brain function that occurs when a damaged liver can no longer clear toxins such as ammonia from the blood. Gut bacteria produce many of those toxins. By reducing those bacteria, rifaximin lowers the toxin load that reaches the brain. Symptoms range from confusion and personality changes to drowsiness and, in severe cases, coma. The condition most often affects people with cirrhosis.

The FDA first approved Xifaxan in 2004 for travelers’ diarrhea. In 2010 it added a use to reduce the risk of hepatic encephalopathy recurring in adults. In 2015 it added IBS with diarrhea, or IBS-D, in adults. Patients taking it for hepatic encephalopathy often use it alongside lactulose, a laxative that also helps clear ammonia.

The two main uses follow different schedules. For IBS-D, rifaximin is given as a two-week course that can be repeated if symptoms return. For hepatic encephalopathy, patients usually take it every day on an ongoing basis, which makes the monthly price more consequential.

Xifaxan sits in the middle of the 2027 list on price. It costs far less than the cancer drugs, but more than the inhalers and diabetes pills. That middle position means plan design matters a great deal. A patient paying coinsurance on a $1,000 drug will see a meaningful change from the old price, while a patient on a flat specialty-tier copay may notice little difference.

Like every drug on the list, Xifaxan must appear on all Part D formularies in 2027.

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Vraylar, AbbVie’s antipsychotic for schizophrenia, bipolar I disorder and major depressive disorder, will have a Medicare negotiated price of $770 for a 30-day supply in 2027. That is 44% below its 2024 list price of $1,376.

Vraylar’s generic name is cariprazine. Hungarian drugmaker Gedeon Richter discovered it, and it reached the U.S. market through a partnership with Forest Laboratories, which later became part of Allergan and then AbbVie. It is an atypical, or second-generation, antipsychotic taken as a once-daily capsule.

Cariprazine is a partial agonist at dopamine D2 and D3 receptors, meaning it partly activates them instead of fully blocking them. It binds especially tightly to D3 receptors, a trait that sets it apart from many other antipsychotics. It also acts on several serotonin receptors.

The FDA approved Vraylar in 2015 for schizophrenia and for manic or mixed episodes of bipolar I disorder. It added bipolar depression in 2019. In 2022 it was approved as an add-on to antidepressants for adults with major depressive disorder, which widened its potential patient base.

Medicare is a major payer for psychiatric drugs. Part D covers people 65 and older, and it also covers younger people who qualify for Medicare through disability, a group that includes many people living with serious mental illness.

Coverage of Vraylar itself is not new. Part D rules already require plans to cover substantially all drugs in six protected classes, and antipsychotics are one of them. What changes in 2027 is the price on which patients’ coinsurance and the program’s spending are based.

Like all antipsychotics, Vraylar carries a boxed warning about a higher risk of death in older adults with dementia-related psychosis, a use for which it is not approved. Its label also carries a boxed warning, shared with antidepressants, about suicidal thoughts and behaviors in children and young adults.

A plan’s 2027 formulary shows Vraylar’s tier and any prior authorization requirement. Patients can check both before open enrollment ends December 7, 2026.

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Tradjenta, a once-daily pill for type 2 diabetes, will cost Medicare $78 for a 30-day supply under its 2027 negotiated price. That is 84% below its 2024 list price of $488, the second-deepest percentage cut in the round.

Boehringer Ingelheim and Eli Lilly $LLY market Tradjenta, whose generic name is linagliptin. The FDA approved it in 2011. It belongs to the DPP-4 inhibitor class, sometimes called gliptins. DPP-4 is an enzyme that breaks down incretin hormones, including GLP-1. By blocking it, linagliptin lets the body’s own incretins last longer, which boosts insulin release and curbs glucose production after meals.

That links Tradjenta to semaglutide on the same list. Both act on the GLP-1 system, but in different ways. Semaglutide is a synthetic version of the hormone and produces a much stronger effect. DPP-4 inhibitors give a milder lift to the body’s natural supply. They are generally weight-neutral and carry a low risk of low blood sugar when used without insulin or sulfonylureas.

Linagliptin stands out within its class because the body clears it mainly through the liver and bile rather than the kidneys. Patients with reduced kidney function, which is common among older adults with diabetes, generally do not need a lower dose.

Tradjenta also has an unusual status in the program. In January 2026, CMS selected it for renegotiation as part of the third round, alongside 15 newly selected drugs that include the first Part B drugs given in doctors’ offices. Prices from that round would take effect January 1, 2028. That means Tradjenta’s $78 price could change after just one year.

The DPP-4 class is well represented across both rounds. Januvia, Merck $MRK’s DPP-4 inhibitor, was in the first round, with a 2026 negotiated price of $113 against a 2023 list price of $527. Janumet, which pairs Januvia’s active ingredient with metformin, is also on the 2027 list.

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Janumet and Janumet XR, Merck $MRK’s combination pills for type 2 diabetes, will have a Medicare negotiated price of $80 for a 30-day supply in 2027. Their 2024 list price was $526, making the 85% reduction the largest percentage cut among the 15 drugs.

Janumet combines two medicines in one tablet. Sitagliptin, the active ingredient in Januvia, is a DPP-4 inhibitor that helps the body keep more of its own insulin-boosting hormones active after meals. Metformin, a drug in use for decades, lowers the amount of glucose the liver releases and improves the body’s response to insulin. Metformin is widely recommended as a first medicine for type 2 diabetes, and doctors often add a second drug when it is not enough on its own.

The FDA approved Januvia in 2006 and Janumet in 2007. Janumet XR, an extended-release version taken once a day, followed in 2012. The standard version is usually taken twice daily with meals, which can ease the stomach upset metformin sometimes causes.

Combination pills cut the number of tablets patients take each day. For older adults managing several chronic conditions, a simpler regimen can make it easier to stay on treatment.

Janumet’s new price sits below that of its single-ingredient sibling. Januvia’s negotiated price, in effect since January 1, 2026, is $113 for a 30-day supply. Janumet’s 2027 price of $80 came out of a separate negotiation for the combination product.

The figures CMS published come with a caveat. The agency describes its savings numbers as estimates that assume drugmakers keep taking part in Medicare. The negotiated prices are binding on participating manufacturers, but the projected savings depend on how many people use each drug and how plans structure their benefits.

With three diabetes products on the 2027 list — semaglutide, Tradjenta and Janumet — type 2 diabetes is the condition with the most drug options carrying a negotiated price in the second round.

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Otezla and its extended-release version, Otezla XR, will have a Medicare negotiated price of $1,650 for a 30-day supply in 2027. That is 65% below the 2024 list price of $4,722.

Amgen $AMGN sells Otezla, whose generic name is apremilast. Celgene developed the drug. Amgen bought it for $13.4 billion in 2019, when Celgene had to sell it so its merger with Bristol Myers Squibb $BMY could clear antitrust review.

Apremilast is a phosphodiesterase 4, or PDE4, inhibitor. By blocking that enzyme inside immune cells, it reduces production of several inflammatory signals that drive skin plaques and joint swelling. Unlike many treatments for moderate to severe psoriasis, it is a pill rather than an injection or infusion, and it does not require routine lab monitoring.

The FDA approved Otezla in 2014 for psoriatic arthritis and plaque psoriasis. In 2019 it added oral ulcers associated with Behçet’s disease, a rare inflammatory disorder that affects blood vessels and causes painful mouth sores, among other symptoms. Otezla XR offers once-daily dosing in place of the standard twice-daily tablets. Common side effects include diarrhea, nausea and headache, which often ease after the first few weeks.

Otezla is not the first psoriasis treatment with a Medicare-negotiated price. Two injectable drugs, Enbrel and Stelara, were in the first round, which took effect in 2026. CMS has listed Stelara for removal from the program effective January 1, 2027, because biosimilar versions are now on the market. Once a lower-cost competitor arrives, the program steps back.

Psoriasis and psoriatic arthritis are long-term conditions, so the yearly gap between the two prices is wide. At the negotiated price, 12 months of Otezla comes to about $19,800, compared with about $56,700 at the 2024 list price.

Medicare open enrollment runs from October 15 to December 7, 2026, for coverage that starts January 1, 2027. Patients taking Otezla, or any of the 15 drugs, can use that window to compare how each available plan covers their prescriptions.