The Trump administration on Tuesday announced a set of new, lower prices for 15 medications covered by Medicare, the latest outcome of a negotiation process established by the Inflation Reduction Act, a 2022 law enacted without a single Republican vote. The announcement concludes the second round of negotiations between Medicare and pharmaceutical manufacturers. It comes even as President Donald Trump has repeatedly attacked the law, campaigned on rolling it back, and advanced policies that narrow its scope.
The 15 drugs selected for this round include treatments for diabetes, obesity, breast cancer, prostate cancer, neurological diseases, depression, blood cancers, lung diseases, and gastrointestinal conditions. They range from high-spend specialty medications to widely used products such as Ozempic, which will have a negotiated price of $277 per month when the changes take effect in 2027. The Centers for Medicare and Medicaid Services estimated that if the newly negotiated prices had been in effect last year, Medicare would have saved $12 billion.
The Inflation Reduction Act granted Medicare the authority to negotiate the prices of high-cost drugs for the first time in the program’s history. Republican lawmakers denounced the law at the time, with House GOP leaders calling it “disastrous” and criticizing “the mandate from bureaucrats to artificially set prescription drug prices.” Yet the Trump administration continues to benefit politically from the law’s operation, even as it works to limit it.
Since taking office, Trump has moved to weaken key parts of the negotiation program. He signed a measure exempting certain high-priced drugs from future Medicare negotiations. Critics argue the exemption provides a multibillion-dollar windfall to pharmaceutical companies and undercuts the purpose of the law. Despite that, Trump-appointed officials presented Tuesday’s results as the product of Trump’s own leadership.
Robert F. Kennedy Jr., secretary of the Health and Human Services Department, linked the outcomes to Trump’s direction, saying the results stemmed from a directive to “stop at nothing to lower healthcare costs for the American people.” CMS Administrator Mehmet Oz argued that the second round of negotiations outperformed the earlier negotiations carried out under the Biden administration. Oz said, “This year’s results stand in stark contrast to last year’s.” He added that his team had “achieved substantially better outcomes for taxpayers and seniors in the Medicare Part D program — not the modest or even counterproductive ‘deals’ we saw before.”
Health policy experts challenged the comparisons. They noted that the drug lists between the first and second rounds differ, making direct comparisons unreliable. They also underscored that the law enabling both rounds was created during the Biden administration and that its structure determines the price outcomes, not changes in negotiation technique.
Democrats highlighted these points in their response to the announcement. Senator Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee and one of the architects of the legislation, said, “Democrats took on Big Pharma by giving Medicare the power to negotiate on behalf of the tens of millions of seniors that want lower drug prices while every Republican voted against it.” Wyden continued, “Today’s announcement is a result of that effort by Democrats to lower health costs for older Americans.” He added criticism of Republican changes to the law, noting, “Republicans neutered future Medicare drug price negotiations by adding delays and exemptions to some of the most expensive drugs, especially cancer drugs like Keytruda.”
Policy advocates also raised concerns about legislative efforts to weaken the program. Steve Knievel, an access to medicines advocate at Public Citizen, pointed to recent exemptions and additional proposals backed by the Trump administration and Republican lawmakers. Knievel said, “Drug corporations already secured a $9 billion giveaway from President Trump and congressional Republicans paid for by taxpayers and cancer patients through the Big Ugly Bill, and they are trying to go even further to delay and exempt price negotiations for more blockbuster drugs.” He argued that “policymakers must reject these efforts to undermine Medicare drug price negotiations.” Knievel called for strengthening the program by “providing everyone access to negotiated prices, negotiating lower prices for more drugs sooner, and ensuring drug corporations can no longer rip us off by charging the highest prices in the world for medications.”
The negotiated price list reflects the government’s focus on drugs that generate large federal expenditures and have been on the market for many years. The new price for Xtandi, a treatment for prostate cancer, is $7,004. For Ibrance, a breast cancer drug, the new price is $7,871. Pomalyst and Calquence, which treat blood cancers, will have prices of $8,650 and $8,600. Other drugs on the list include Trelegy Ellipta at $175, Linzess at $136, Otezla at $1,650, Xifaxan at $1,000, Austedo products at $4,093, Ofev at $6,350, Vraylar at $770, Tradjenta at $78, Breo Ellipta at $67, and Janumet products at $80.
These prices apply only to Medicare and start in 2027. While the negotiated discounts will substantially reduce federal spending, they are unlikely to significantly lower most Medicare beneficiaries’ personal spending on prescriptions. Under the Inflation Reduction Act, out-of-pocket costs for drugs taken at home will already be capped at about $2,200 annually in 2027, depending on inflation and overall drug spending. The new negotiated prices primarily affect the federal budget rather than individual cost sharing beyond the cap.
Experts evaluated the new prices as a sign that the negotiation authority is functioning successfully. Stacie B. Dusetzina, a health policy professor at Vanderbilt University, described the results as “strong,” while expressing disappointment that the negotiated prices for Novo Nordisk’s weight loss drug did not match the prices in a separate voluntary agreement. “I would have preferred that they pushed to have those prices set in stone,” she said. Juliette Cubanski, a Medicare expert at KFF, said that “in both the Biden and Trump negotiations, we’re seeing that the law is having the intended effect of delivering lower prices to the Medicare program.” Dr. Benjamin N. Rome, a researcher at Brigham and Women’s Hospital, called the results “great news” and noted that the second round likely produced higher savings because it included several cancer drugs that have faced little discounting under the current pricing system.
The pharmaceutical industry has resisted the negotiation requirements since the law’s passage. Drug manufacturers have filed multiple lawsuits challenging the program and recently lost their sixteenth court case. At the same time, pharmaceutical companies are lobbying for legislation that would add new exemptions and weaken the negotiation framework.
The political tension surrounding the new prices is heightened by Trump’s separate pursuit of voluntary pricing agreements with companies like Pfizer and AstraZeneca. These arrangements exist outside the Inflation Reduction Act’s negotiation program. In the case of Novo Nordisk’s diabetes and obesity drugs, the voluntary agreement would allow the government to pay $245 a month for certain Medicare and Medicaid patients beginning next year. The coverage for people using the drug for obesity would apply only to specific patients who meet eligibility criteria and would cap copayments at no more than $50 a month. The administration did not clarify how these voluntary prices will interact with the newly negotiated ones.
The first round of Inflation Reduction Act negotiations occurred during the Biden administration and applied to 10 drugs. Biden officials said that if the negotiated prices had been in place in 2023, Medicare would have saved $6 billion, cutting spending on those drugs by 22 percent. While experts caution against comparing the first and second rounds directly, both reflect substantial reductions in federal spending.
As the Trump administration promotes the negotiated prices, the competing narratives around the Inflation Reduction Act and Medicare savings continue to evolve. Democrats describe the results as proof that the law is working as intended, while Trump officials work to frame the outcome as a product of Trump’s leadership even as they back measures that limit negotiation.
“Today’s announcement is a result of Democratic efforts to lower health costs for older Americans,” Wyden said.
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