CMS Must Send Final Written Price Offers to 15 Drug Makers by September 30 in Third Negotiation Cycle

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 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.