Starting January 1, 2026, Medicare’s first set of negotiated “Maximum Fair Prices” for certain Part D medications kicks in, and that’s why you’re seeing headlines about prices slashed. These negotiated prices apply to a first group of 10 high-spend drugs, but what you pay at the pharmacy can still vary by plan design and formulary rules. The smartest move is to know which meds are on the list, then double-check how your plan covers your specific dose and pharmacy. Here are eight of the medications included in that first negotiation group, plus what to do next.
1. Eliquis: A Big Target for Blood Clot Costs
Eliquis is commonly used to prevent and treat blood clots, and it’s one of the highest-spend drugs in Part D. If you take it, don’t assume your copay automatically drops on January 1—your plan’s tier and coinsurance still matter. Ask your plan or pharmacist whether your specific Eliquis dose is covered under the negotiated price and whether your preferred pharmacy is in-network. If you’re on coinsurance, even a lower underlying price can make a noticeable difference at checkout. This is one of the clearest examples of prices slashed meeting real-life budget relief, but you have to confirm how it shows up in your plan.
2. Jardiance: Prices Slashed for Diabetes and Heart Health
Jardiance is used for type 2 diabetes and also has heart-related uses for many patients. Because it’s widely prescribed, even small copay changes can add up over a year. Your action step is to check whether your plan requires prior authorization or step therapy, because those rules can still affect access even when prices are lower. If you’ve been using manufacturer savings cards in the past, ask how the new Medicare pricing interacts with what you’re paying now. Keep your receipts or Explanation of Benefits for January, so you can spot errors early.
3. Xarelto: Another Anticoagulant With Major Spending
Xarelto is another blood thinner on the negotiated list, often prescribed for clot prevention and treatment. If your plan places it on a higher tier, the negotiated price may matter most if you pay coinsurance instead of a flat copay. Ask your plan what your expected out-of-pocket cost will be for a 30-day supply in 2026 and whether mail order is cheaper for you. If you’ve ever skipped doses due to cost, this is the moment to talk to your prescriber about adherence and refill timing. Lower plan costs can also change the best time to fill, especially if you use monthly budgeting.
4. Januvia: A Standout Example of a Big Drop
Januvia is a diabetes medication, and it’s been highlighted as one of the steepest reductions in the first set of negotiated prices. AARP notes that a 30-day supply is set at $113 in 2026, down sharply from the 2023 list price they cite. Your next step is to check whether your plan uses preferred pharmacies, because that can still swing what you pay. If you take Januvia alongside other diabetes meds, ask your pharmacist to review your whole regimen for cost-effective coverage under your plan.
5. Farxiga: Savings That Can Affect Multiple Conditions
Farxiga is used for type 2 diabetes and is also prescribed for other cardiovascular and kidney-related conditions. If you’re taking it for a non-diabetes indication, coverage rules can look different, so verify your plan’s requirements. Ask whether your dose is subject to utilization management, and confirm whether a 90-day fill changes your total cost. If your plan offers the Medicare Prescription Payment Plan option, consider using it to spread monthly costs more evenly through the year.
6. Entresto: A High-Impact Heart Medication on the List
Entresto is used for certain heart failure patients and has been a major Part D spending drug. If you’re on it, your best move is to verify whether your plan charges coinsurance, because that’s where underlying price changes tend to matter most. Ask your cardiology office if they have a preferred way to handle refills and prior authorizations so you don’t face delays after January. Also, check whether your plan changed its formulary in 2026, because plan coverage details can shift year to year. Even with a negotiated price, you still want the “admin” side handled smoothly.
7. Enbrel: Biologic Costs Meet the New Negotiation Era
Enbrel is a biologic used for autoimmune conditions, and it’s one of the negotiated drugs for 2026. Biologics often come with specialty pharmacy rules, so confirm where you’re required to fill them. Ask whether your plan has a preferred specialty pharmacy and whether that affects shipping fees or refill timing. If you’re offered a biosimilar alternative, ask your prescriber to explain the clinical differences and your plan to explain the cost differences. The goal is to protect both your budget and your continuity of care.
8. Stelara: Specialty Coverage Details Matter Here
Stelara is another high-cost drug on the negotiated list, used for certain autoimmune conditions. With specialty meds, your out-of-pocket amount can be driven by coinsurance, deductibles, and pharmacy network rules, so it’s worth doing a quick plan check-in. Confirm whether your plan requires prior authorization and how long approvals typically take so you can avoid gaps in therapy. If your costs are still high early in the year, ask about payment smoothing options and any patient support resources your provider office can point you to. A lower negotiated price is meaningful, but getting the “how” right is what makes it usable.
Your January Game Plan for Lower Drug Costs
Treat January like a quick audit month: check one refill, one receipt, and one plan rule at a time. The negotiated Maximum Fair Prices take effect January 1, 2026, but your plan still determines the final copay or coinsurance you see. If something looks wrong, call your plan right away while the transaction is fresh and fixable. If you’re on expensive meds, ask about spreading costs through the year so the first few fills don’t feel brutal.
Which matters more to you right now—lower monthly pharmacy costs, fewer coverage surprises, or a plan that’s simpler to manage?
What to Read Next…
6 Medicare Premium Changes Most People Won’t Notice Until Too Late
Cost-Plus Drug Programs Are Making Major Pricing Updates This Winter
9 Medicare Terms Retirees Misunderstand Every January
Large Drugstore Chains Are Cutting Hours, Affecting Medication Access
6 Medicare Part D Gaps Seniors Only Notice in January
Catherine is a tech-savvy writer who has focused on the personal finance space for more than eight years. She has a Bachelor’s in Information Technology and enjoys showcasing how tech can simplify everyday personal finance tasks like budgeting, spending tracking, and planning for the future. Additionally, she’s explored the ins and outs of the world of side hustles and loves to share what she’s learned along the way. When she’s not working, you can find her relaxing at home in the Pacific Northwest with her two cats or enjoying a cup of coffee at her neighborhood cafe.
Read More
Most Workers Do Not Want the Old Office Routine With vaccinations increasing and the economy…
One old dirty trick is still with us. However, other financial matters are changing quickly.…
Why Did Stock Explode When Jobs Bombed? April’s jobs report was lower than expected, but…
You may read or hear the term “inflation fears” being used with increasing frequency. In…
For millions of retirees, Medicare Advantage plans seem like the perfect solution–affordable premiums, bundled benefits,…
It started with empty spots on grocery store shelves amid the pandemic. As a…
Comments