Medicare selects Botox and Trulicity among 15 drugs for next round of price negotiations
Medicare named 15 high-cost drugs for a new cycle of price negotiations, including Botox and the diabetes drug Trulicity, with negotiated prices slated to take effect in 2028 and manufacturers required to decide whether to participate by late February.
Medicare has selected 15 high-cost prescription drugs for its next round of price negotiations, including AbbVie’s Botox and Eli Lilly’s Trulicity. The selections are part of the Medicare Drug Price Negotiation Program, with negotiations expected to take place in 2026 and the resulting prices scheduled to become effective on January 1, 2028.
The list is notable both for its size and for what it targets: drugs that collectively accounted for roughly $27 billion in Medicare spending between November 2024 and October 2025, according to the Centers for Medicare & Medicaid Services. The program’s latest cycle also includes, for the first time, drugs payable under Medicare Part B, expanding beyond Part D-only selections.
Manufacturers must decide by February 28, 2026, whether they will participate in negotiations. If a company declines, it faces a choice between steep excise taxes or withdrawing affected products from Medicare and Medicaid coverage—pressure that supporters say is necessary to counter high prices, and opponents say amounts to government price-setting.
Patient advocates argue the negotiations can reduce out-of-pocket costs for seniors and improve affordability for widely used treatments. Industry groups have criticized the negotiation structure, warning it could affect innovation incentives and investment decisions, while legal challenges to the program continue in the background.
Beyond Botox and Trulicity, the selected list spans drugs for conditions including COPD, HIV, asthma, arthritis, inflammatory bowel disease, depression and multiple cancers. Medicare also said it intends to renegotiate the price of the diabetes drug Tradjenta, highlighting that renegotiations can occur when market conditions shift.