News Release

Medicare and Drug Prices


Recent analysis in the Journal of Managed Care and Specialty Pharmacy predicts that Medicare will most likely negotiate prices for 38 Medicare Part D drugs and two Part B drugs between 2026 and 2028. These 40 products eligible for negotiation––including inhalers, antidiabetics, anticoagulants and more––accounted for $67.4 billion in gross Medicare spending in 2020. 

    Hernandez is an associate professor of clinical pharmacy at the Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego.

Hernandez told the Institute for Public Accuracy: “It’s important for the public to know which [drug] classes we’ll see negotiation in” in the next few years, including “new anticoagulants, antidiabetics, cancer drugs, and multi-virals and HIV drugs.” The drugs that Hernandez predicts will be negotiated concentrate the majority of the market, and accounted for 20 percent of spending in 2020. Beneficiaries can expect that their out-of-pocket costs will go down for these drugs. This will all make a “big difference in spending.”

Hernandez was surprised that only two drugs from Part B—drugs administered by providers, like injectables and infusions—will be eligible for negotiation based on most recently available public data.

The analysis also found that most high-spend drugs that are ineligible for negotiation already have a biosimilar or generic version on the market.