• Posted January 29, 2026

Medicare to Negotiate Lower Prices for Botox and 14 Other Major Drugs

Fifteen prescription medications, including Botox and the diabetes drug Trulicity, will be the focus of federal price negotiations that could lower prices for Medicare patients.

An outgrowth of the U.S. Inflation Reduction Act of 2022, the talks aim to lower costs for some of the most expensive treatments used by seniors. Results of the first round of negotiations with drug makers went into effect this year.

The medications chosen for this negotiation cycle represent roughly $27 billion in total prescription drug spending under Medicare Part B and Part D, according to the Centers for Medicare and Medicaid Services (CMS). 

Part B covers drugs like intravenous chemotherapy that are administered in a medical facility; Part D covers prescription drugs. 

Prices negotiated in the new round of talks will go into effect in 2028.

Manufacturers have until Feb. 28 to decide if they will participate. While companies can opt out, doing so would likely result in their drug being removed from Medicare's covered drugs list  — one of the nation’s largest markets. 

To date, no drugmaker has walked away from the program during previous negotiation rounds, according to NBC News.

The list covers the top 15 highest spending drugs for Medicare across a variety of serious health conditions. The medications up for negotiation this year include:

Cancer drugs: Erleada (prostate cancer); Kisqali (breast cancer); Verzenio (breast cancer); and Lenvima (several cancers)

Autoimmune treatments: Cimzia (Crohn's disease); Cosentyx (psoriasis); Entyvio (Crohn's disease and ulcerative colitis); Orencia (rheumatoid arthritis); and Xeljanz and Xeljanz XR (autoimmune conditions)

Chronic conditions: Anoro Ellipta (COPD); Biktarvy (HIV); Trulicity (type 2 diabetes); Rexulti (major depressive disorder, schizophrenia, or agitation associated with dementia due to Alzheimer’s disease); and Xolair (asthma and allergies)  

Botox is included for its medical applications rather than cosmetic ones. Medicare covers the drug for conditions such as chronic migraines, overactive bladder and muscle spasms.

The Trump administration also plans to renegotiate the price for the diabetes medication Tradjenta, which was part of a previous round of talks. 

This follows a recent announcement of lower costs for Ozempic and Wegovy, which are scheduled to go into effect in 2027, according to NBC News.

More information 

The Centers for Medicare and Medicaid Services has more on the Medicare Drug Price Negotiation Program.

SOURCE: NBC News, Jan. 27, 2025