Drug prices & Part D
CMS Must Send Final Written Price Offers to 15 Drug Makers by September 30 in Third Negotiation Cycle
The final statutory step before drug manufacturers accept or reject Medicare prices arrives this week. CMS must issue written maximum fair price offers by September 30, and manufacturers have until October 31 to respond. Agreed prices would take effect in 2028.
By the Goodsurance editorial teamSeptember 23, 2026
The third cycle of the Medicare drug price negotiation program reaches a critical statutory deadline this week: the Centers for Medicare and Medicaid Services must deliver a final written offer for the maximum fair price on each of the 15 selected drugs no later than September 30, 2026.
Once manufacturers receive a written offer, they have 30 days to respond in writing. The acceptance deadline for this cycle is October 31, 2026. If a manufacturer rejects the final offer and no agreement is reached by that date, it could face a significant excise tax on affected U.S. drug sales, as established by the Inflation Reduction Act.
The government has until September 30 to send final price offers on 15 high-cost Medicare drugs. Here is what happens next.
The third cycle is notably broader than the first two. It includes, for the first time, drugs covered under Medicare Part B, which are typically administered by injection or infusion at a clinic or doctor's office rather than dispensed at a pharmacy. CMS announced in March 2026 that all manufacturers of the selected drugs signed agreements to participate.
The negotiation process has moved through several prior stages: an initial offer from drug companies in early summer, a formal exchange period, and a face-to-face meeting window that closed September 11, 2026. The written offer step is the final stage before manufacturers give a binding yes or no.
If all 15 negotiations succeed, the resulting maximum fair prices would bring the total number of drugs with negotiated Medicare prices to 35. Those prices would take effect January 1, 2028, reducing costs for Medicare beneficiaries who take the affected drugs under Part B or Part D.
In plain words
Medicare is negotiating lower prices for 15 drugs. By September 30, the government must send final price offers to the drug companies. The drug companies then have until October 31 to say yes or no. If they say no and do not agree on a price, they could face a large tax on their U.S. drug sales. These are all high-cost drugs, and some of them are given at a doctor's office rather than picked up at a pharmacy. If deals are reached, patients could pay less for these drugs starting in 2028.
Understand the basics first
Source: CMS
Read at the source →