Inside Medicare's summer of drug price talks

While the week's attention went to fireworks, one of the larger money processes in Medicare moved quietly into its bargaining phase. In January, CMS named 15 more high cost drugs for the third cycle of Medicare drug price negotiation, including, for the first time, medicines given in a doctor's office under Part B, such as Botox, Orencia, and Entyvio, alongside Part D drugs like Trulicity, Biktarvy, and Cosentyx. Every manufacturer chose to participate. Under the schedule CMS published, the agency sent each company an initial offer, its proposed maximum fair price with a written justification, by June 1, and companies then had 30 days to accept or make a counteroffer. That window closed at the start of July, which is what makes this a summer story: the two sides are now negotiating in earnest, with up to two more meetings per drug through the summer and fall before the process must end by November 1. Any agreed prices take effect January 1, 2028. Nothing about this changes a pharmacy bill today, and the timeline is worth keeping straight, because three separate waves are easy to blur. The first ten negotiated prices took effect this past January. A second set of 15 drugs, which public reporting says includes Ozempic and Wegovy, takes effect January 1, 2027. And this third round, the one being bargained right now, lands in 2028. For day to day budgeting, the stronger protection remains the annual cap on out of pocket Part D drug costs, reported at $2,100 for 2026. There is a real debate running underneath: drugmakers argue that negotiation trims the revenue that funds future research, while supporters point to the projected savings for taxpayers and patients. Either way, a negotiation headline in August is not a price cut in August; the calendar runs to November 1, and the prices to 2028.