Even as the Trump administration works to implement its "most favored nation" pricing system, the U.S. government continues to advance efforts to negotiate Medicare drug prices as enabled by the Inflation Reduction Act.
On Tuesday, the Centers for Medicare & Medicaid Services unveiled the next 15 high-spend medicines up for price negotiations under the program.
Meds up for first-time Medicare price negotiations this year include GSK's inhaler Anoro Ellipta, Gilead's HIV blockbuster Bitkarvy, AbbVie's Botox and Botox Cosmetic brands, Takeda's inflammatory bowel disease drug Entyvio and Johnson & Johnson prostate cancer medicine Erleada, according to a Jan. 27 release from the CMS.
In addition, Novartis' breast cancer medicine Kisqali, Eisai's cancer therapy Lenvima, Lundbeck and Otsuka's atypical antipsychotic Rexulti, Eli Lilly's diabetes drug Trulicity and its breast cancer treatment Verzenio are also due up for first-time negotiations, according to the government.
Rounding out the list are Roche and Novartis' Xolair for food allergies, chronic hives and other uses, plus immunology biologics Cosentyx, Cimzia, Orencia and Xeljanz from Novartis, UCB, Bristol Myers Squibb and Pfizer, respectively.
Also for the first time, the government will renegotiate a drug's price under the IRA system, tagging Boehringer Ingelheim's diabetes med Tradjenta for renegotiations. The drug was previously included in last year's batch of pricing talks.
After the negotiation process for the drugs kicks off this year, their new Medicare prices will become effective in early 2028, according to the CMS. Drugmakers have until the end of February to decide whether to participate in the process.
About 1.8 million people used one or more of the 15 drugs through Medicare Part D or Part B between November 2024 and October 2025, the CMS said. The batch of 15 meds accounted for about $27 billion in prescription drug spending in Medicare over that timeframe, or about 6% of total Part B and Part D spending, CMS said.
The list also includes the first Medicare Part B medicines to face IRA-enabled cost cuts. Drugs in this group are typically given by doctors rather than obtained at pharmacies.
The move comes shortly after the first batch of IRA-enabled Medicare price cuts went into effect at the start of the year. The pharmaceutical industry has wagered a public campaign against the IRA price negotiations, likening the system to government price controls rather than genuine negotiations, but so far it hasn't been able to meaningfully resist the IRA measures. Several IRA lawsuits are making their way to the Supreme Court, Endpoints News reported this week.
The Trump administration continues to implement IRA measures even as President Donald Trump's preferred drug pricing mechanism in his second term centers on aligning international and domestic drug costs. His "most favored nation" push has resulted in pricing concessions from 16 drugmakers, though many of the details of those deals have been kept from the public. In general, the deals are designed to provide direct patient access to certain drugs at discounted prices.
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