CMS announced the next 15 drugs for price negotiation effective in 2027. These 15 drugs will proceed through the negotiation process in 2025, ultimately resulting in negotiated prices for Medicare Part D plans and beneficiaries. Let’s review these selected drugs compared to the initial set that are in place for 2026.
https://www.cms.gov/files/document/factsheet-medicare-negotiation-selected-drug-list-ipay-2027.pdf
Cost
CMS reported that the ten negotiated drugs for 2026 accounted for approximately $56 billion in spending during 2023. In contrast, the fifteen drugs selected for price negotiation in 2027 accounted for $40 billion in spending during the period from November 2023 to October 2024, with the top ten (by total spend value), totaling $35 billion. Additionally, the change to permit coverage for weight loss in Medicare occurred after this spend measurement period, and the value would likely increase with additional utilization of Wegovy.
Enrollees
The 2026 negotiated drugs were utilized by 10.5 million Medicare enrollees during the 2023 year. The 2027 negotiated drugs were utilized by 5.7 million Medicare enrollees over the 12-month measurement period. The top 10 drugs in 2027, sorted by Medicare enrollee utilization, totals 5.6 million enrollees, demonstrating the impact of more specialty products selected for 2027. Based on these statistics, fewer Medicare enrollees will be impacted by the 2027 negotiations versus the 2026 negotiations, but this could be misleading since Ozempic, Rybelsus, and Wegovy experienced rapid growth in late 2024 and 2025.
Only one product in 2026 was utilized by less than 20,000 Medicare enrollees, while 3 products in the 2027 list met this threshold.
Therapeutic Category
New therapeutic categories for the 2027 selected drugs include weight loss, asthma/COPD, neurological conditions, pulmonary fibrosis, and constipation. Four oncology products are selected for 2027, compared to only one in 2026. Diabetes continues to be a relevant category in both years, which makes sense due to the prevalence and expenditures.
Summary
CMS announced the 15 drugs for price negotiations effective in 2027 for Medicare Part D. While there are more drugs than the 2026 list, these 15 drugs account for less expenditure and impact fewer Medicare enrollees. This is partially due to the selection of multiple specialty drugs for 2027. How will the list of 2028 selected products differ?