Which Medicare Part D Drugs Get Negotiated Prices in 2027?

The common assumption is that a negotiated price means every counter receipt suddenly shows the same low number. But that is not how Part D works. The truth is more useful: the negotiation sets a maximum fair price for the selected drug, while your plan's benefit rules determine how that lower underlying amount reaches your wallet.

Which prescription drugs will have Medicare-negotiated prices in 2027?

CMS says the following 15 additional Part D drug products will have negotiated maximum fair prices effective January 1, 2027. The list includes products used for diabetes, asthma or COPD, cancer, idiopathic pulmonary fibrosis, gastrointestinal conditions, and mental health conditions, among others.

Do not reduce this to one price per brand name. CMS says the negotiated price applies to covered dosage forms and strengths, so it is not necessarily one retail price for every package. CMS reports that the 2027 negotiated 30-day prices range from $67 for Breo Ellipta, an 83% reduction from its 2024 list price, to $8,650 for Pomalyst, a 60% reduction from its 2024 list price.

The scale explains why the details matter. CMS reports that about 5.3 million of 53 million Part D enrollees used these drugs in 2024, and the drugs represented $42.5 billion, or about 15%, of total Part D gross covered prescription drug costs in 2024. CMS estimated that the 2027 negotiated prices would have reduced 2024 net covered prescription drug costs by $12 billion, or 44%, and estimated $685 million in beneficiary out-of-pocket savings under the defined standard benefit design.

Here is the practical boundary: a selected product is not a blank check for every possible use. KFF reports that the 2027 requirement improves coverage for Medicare-covered uses, while statutory coverage exclusions still apply. Its example is Wegovy: Part D may cover it for cardiovascular disease risk reduction, but Part D generally cannot cover drugs when used for weight loss.

Will my Part D plan automatically charge the new negotiated price?

For an eligible individual receiving a covered selected drug, the negotiated price is required to be available, but your Part D plan still determines the benefit calculation that produces your out-of-pocket charge. CMS states that a participating drug company must ensure the negotiated price is available to eligible individuals and the pharmacies, mail-order services, and other entities that dispense the selected drug to them.

Coverage is stronger than it was before the negotiated-price effective date. KFF says the law requires all Medicare Part D plans to cover each selected drug, including all dosage forms and strengths, when negotiated prices take effect on January 1, 2027. That requirement matters because a plan formulary normally decides which outpatient drugs it covers.

But “covered” and “free” are different words. Medicare.gov says formularies can place drugs in tiers, with lower tiers generally costing less than higher tiers. In 2027, a Part D deductible can be no more than $700, according to Medicare.gov, although some plans have no deductible. After the deductible, the standard Part D design generally uses 25% coinsurance for generic and brand-name drugs until out-of-pocket spending on covered Part D drugs reaches $2,400 in 2027, according to Medicare.gov.

Once the $2,400 out-of-pocket threshold is reached in 2027, Medicare.gov says catastrophic coverage begins automatically and there is no out-of-pocket cost for covered Part D drugs for the rest of that calendar year. That sequence is the hidden cost issue: the negotiated amount can lower the price used in the calculation, while the amount you pay on a particular fill still changes with your stage of coverage. For a fuller explanation of those moving parts, see How Do the 2026 Medicare Part D Deductible, 25% Coinsurance, and $2,100 Cap Work?.

Use this three-part check when the receipt does not match expectations: identify the exact drug product and form, confirm its covered use and plan tier, then match the receipt to the coverage stage on your EOB. Medicare.gov's direct instruction is blunt and useful: contact your plan for details on how negotiated prices might affect you.

Can my plan still require prior authorization for a negotiated drug?

Yes. Medicare.gov says Part D plans may still use prior authorization, step therapy, quantity limits, medication safety checks, and drug-management rules for the drugs they cover, including a drug with a negotiated price.

Prior authorization is a coverage rule, not a new price. Medicare.gov explains that it requires the beneficiary or prescriber to meet the plan's coverage requirements before the plan covers the drug, and the prescriber may need to establish medical necessity. A negotiated maximum fair price does not erase that step.

Do not let a denied or delayed claim turn into an unexplained bill. Ask the plan which rule stopped coverage, what documentation it needs, and whether a prior-authorization exception is available. Medicare.gov says a beneficiary or prescriber can request that exception with a supporting statement explaining that another drug would be less effective or could cause negative health effects.

Starting January 1, 2027, Medicare.gov says a plan may be able to process prior-authorization requests electronically and make decisions accessible through a patient portal. That can make the paperwork easier to track, but it does not guarantee approval. For context on how Medicare authorization rules can differ by coverage type, see Will My Original Medicare Service Need Prior Authorization in 2026?.