CMS Sets 2028 Maximum Fair Prices for 15 Medicare Drugs
Medicare is taking another important step toward lowering prescription drug costs. The Centers for Medicare & Medicaid Services (CMS) has announced the next group of 15 medications that will receive Maximum Fair Prices (MFPs) starting January 1, 2028. These drugs are some of the most widely used and highest‑cost medications covered by Medicare, and for the first time, the selected group includes drugs under both Medicare Part D and Medicare Part B.
The 15 Drugs Selected
CMS chose these medications because they represent some of the highest total Medicare spending and have no generic or biosimilar alternatives. They include treatments for chronic diseases, autoimmune conditions, cancers, asthma, HIV, and more.
Why These Medications Matter
These 15 drugs are used by a large number of Medicare beneficiaries. Between November 2024 and October 2025, about 1.8 million people relied on at least one of these medications. Together, they accounted for roughly $27 billion in Medicare drug spending, which represents about 6% of all Medicare Part B and Part D drug costs during that year.
These high‑cost medications are key targets for negotiation, and earlier cycles of CMS negotiations have already shown that lower prices could have saved Medicare billions of dollars if implemented sooner.
What Happens Next
Manufacturers and CMS will negotiate the new prices throughout 2026, with companies required to decide by February 28, 2026 whether they'll participate. The newly negotiated Medicare Maximum Fair Prices will officially take effect on January 1, 2028.
What This Means for People on Medicare
These new prices are intended to reduce what Medicare pays overall. Individual savings will depend on each person’s Medicare plan, formulary placement, and cost‑sharing structure. Even so, lowering Medicare’s spending on high‑cost drugs is expected to support long‑term affordability and help keep costs more stable for beneficiaries.
Chart: 15 Drugs Chosen for 2028 Maximum Fair Prices
| Drug Name | Common Uses |
|---|---|
| Anoro Ellipta | COPD |
| Biktarvy | HIV‑1 |
| Botox | Chronic migraine, movement disorders |
| Cimzia | Crohn’s disease, arthritis, psoriasis |
| Cosentyx | Psoriasis, psoriatic arthritis |
| Entyvio | Crohn’s disease, ulcerative colitis |
| Erleada | Prostate cancer |
| Kisqali | Breast cancer |
| Lenvima | Thyroid, liver, kidney cancers |
| Orencia | Rheumatoid & psoriatic arthritis |
| Rexulti | Depression, schizophrenia |
| Trulicity | Type 2 diabetes |
| Verzenio | Breast cancer |
| Xeljanz / XR | Rheumatoid & psoriatic arthritis, ulcerative colitis |
| Xolair | Asthma, chronic hives |
Not affiliated with or endorsed by Medicare or any government agency.
Sources
CMS announcement on third‑cycle drug selections and 2028 implementation timeline
[cms.gov]CMS list of 15 drugs selected for negotiation
[ncpa.org]Medicare spending and beneficiary usage data
[healthcare...cenews.com]Additional context on the negotiation process and cost‑sharing considerations
[medicarerights.org]