Medicare selects GLP-1, Botox for negotiations
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Medicare wants to negotiate lower prices for Eli Lilly's GLP-1 drug Trulicity and AbbVie's Botox in its next round of drugmaker negotiations, federal health officials announced Tuesday.
Why it matters: The GOP budget law passed over the summer excluded several high-cost drugs from being selected for negotiations. Still, the 15 drugs chosen accounted for $27 billion of Medicare spending between November 2024 and October 2025, per the Centers for Medicare and Medicaid Services.
- The negotiated prices would take effect in 2028.
- This is the first time that Medicare can select prescription drugs administered in doctors' offices and other outpatient settings for the negotiations.
How it works: Drugmakers must decide by Feb. 28 if they plan to participate in negotiations with the government.
- Those that opt out must either pay an excise tax of up to 95% of their U.S. sales or withdraw their drugs from Medicare and Medicaid coverage.
The other drugs selected are:
- Xolair, an injectable asthma drug from Novartis
- Cosentyx, a psoriasis drug, also from Novartis
- Kisqali, a breast cancer treatment from Novartis
- Verzenio, a breast cancer drug from Eli Lilly
- Anoro Ellipta, a COPD drug from GlaxoSmithKline
- Biktarvy, an HIV medication from Gilead
- Entyvio, a biologic for inflammatory bowel disease made by Takeda
- Erleada, Janssen's prostate cancer drug
- Lenvima, a cancer drug from Eisai
- Orencia, an arthritis medication from Bristol-Myers Squibb
- Rexulti, an antipsychotic made by Otsuka
- Xeljanz, Pfizer's arthritis drug
- Cimzia, a drug for Crohn's disease symptoms made by UCB
Nearly 1.8 million Medicare enrollees used the selected drugs from November 2024 to October 2025.
Zoom out: Medicare said Tuesday that it also wants to renegotiate a price for Boehringer Ingelheim's diabetes drug Tradjenta.
- Medicare last year negotiated the list price of Tradjenta down to $78, an 84% decrease.
- Drugs are eligible for renegotiation if their monopoly status changes and CMS anticipates another round of negotiations would significantly lower the product's price.
Between the lines: This is the first time the Trump administration is selecting the drugs for Medicare price negotiations.
- President Trump has struck separate deals with major drugmakers to lower their U.S. prices. Those companies haven't gotten a reprieve from Medicare price negotiations.
- But the selection criteria for the negotiations are largely outlined in law, which gives the administration less leeway to decide which to pick.
- Drugmakers have filed several lawsuits seeking to stop the program, but none have been successful so far. AstraZeneca has asked the U.S. Supreme Court to take up their challenge of the negotiations.
What they're saying: "Older Americans across the political spectrum consistently say that lowering drug prices is a top priority, and we thank the Administration for protecting Medicare's ability to meet that need," Myechia Minter-Jordan, the CEO of AARP, said in a statement.
The other side: The trade group PhRMA said the negotiations "show why government price setting is the wrong approach for Americans."
