Medicare's Third Drug Negotiation Cycle Enters Its Final Month Before CMS Must Send Written Offers on 15 Drugs

Medicare's third cycle of prescription drug price negotiations has entered its final stretch. Under guidance CMS finalized for the third cycle, the agency must send each participating manufacturer a final written offer of a maximum fair price no later than September 30, 2026. Drug companies then have until October 31 to accept or reject that offer, and the negotiation period closes November 1. Any agreed prices must be published by November 30. Prices produced by this cycle take effect January 1, 2028.

All 15 manufacturers of the drugs selected for this cycle confirmed their participation in March 2026. This cycle is the first to include drugs billed under Medicare Part B, which covers infused and injected medicines typically administered in a clinical setting, alongside drugs covered under Medicare Part D, which are dispensed at the pharmacy counter. The selected drugs span cancer, diabetes, autoimmune conditions, and other serious illnesses.

The third cycle follows two earlier rounds. The first cycle produced negotiated prices on 10 drugs that took effect January 1, 2026. A second cycle of 15 drugs will produce prices effective in 2027. In all three cycles, CMS and each manufacturer exchange written offers and counteroffers before CMS issues a final price position.

For beneficiaries enrolled today, this cycle's outcome will not change 2026 or 2027 out-of-pocket costs. If agreements are reached, the resulting maximum fair prices will lower what Medicare and patients pay for the 15 targeted drugs beginning in January 2028.