The Medicare drug price negotiation program just crossed a line it had not touched before. On January 27, 2026, CMS named its Round 3 list: 15 drugs, including the first-ever Part B drugs, with negotiated prices effective in 2028. Rounds 1 and 2 were limited to Part D. Round 3 reaches medications administered in a doctor’s office or clinic, changing the math for a specific slice of Medicare enrollees.
If you fill prescriptions at a pharmacy and never see a nurse with a needle, this round matters mostly at the Part D level. Your savings will depend on your plan’s cost-sharing, and the annual Part D out-of-pocket cap already limits catastrophic exposure. The reader who should keep going is the one whose treatment involves an infusion chair or an injection billed under Part B. That is where the cost-sharing math moves most directly.
Why Part B Drugs Hit Differently
Original Medicare has no annual out-of-pocket ceiling. Without Medigap or other supplemental coverage, after the $283 Part B deductible in 2026, the beneficiary generally owes 20% of the Medicare-approved amount, dose after dose, with no annual stop sign. On a biologic with a $30,000 annual allowed cost, that is roughly $6,000 out of pocket. On Botox for chronic migraine, Entyvio for Crohn’s disease, or Xolair for severe asthma, the arithmetic can swallow several Social Security checks.
That is why Round 3 matters. For beneficiaries paying their own Part B coinsurance, a lower Medicare price should mean a smaller bill. But the size of that reduction is not known yet. If the Medicare price fell 40%, for example, a $6,000 annual coinsurance could fall to roughly $3,600. CMS must publish the actual negotiated prices by November 30, 2026. Until then, any savings figure is an illustration, not a promise.
The 15 Drugs and What They Treat
Round 3 covers nearly 1.8 million Medicare beneficiaries and $27 billion in Medicare spending. The five drugs commonly administered in clinical settings are Botox, Cimzia, Entyvio, Orencia, and Xolair. The remaining drugs include Biktarvy for HIV, Trulicity for type 2 diabetes, Cosentyx for psoriasis, Verzenio and Kisqali for breast cancer, Erleada for prostate cancer, Lenvima for several cancers, Anoro Ellipta for COPD, Rexulti for psychiatric conditions and Alzheimer’s-related agitation, and Xeljanz for autoimmune conditions.
CMS also selected Tradjenta, a Round 2 diabetes drug, for renegotiation. Its current negotiated price, 84% below its 2024 list price, takes effect in January 2027 before any revised figure would apply.
The Timing Trap
Negotiated prices take effect January 1, 2028, not now. A beneficiary paying 20% coinsurance on Entyvio this year still owes coinsurance based on the applicable Medicare payment amount through 2027. Anyone planning treatment or considering a Medigap change because the price is “dropping soon” needs that date pinned down. Delaying a chronic-disease biologic to chase a future discount is almost never worth the clinical cost.
What to Do Before 2028
Three actions apply, in order of dollar impact:
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Check Whether Your Drug Is on the List. If your Part B infusion or injection is one of the five physician-administered drugs named above, the 2028 price will be reflected automatically in Medicare’s payment calculation. No enrollment step is required.
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Reprice Your Medigap Coverage After CMS Publishes the Numbers. Plan G covers Part B coinsurance, including these drugs. Once CMS announces the negotiated prices, compare your premium with your remaining Part B exposure. Remember that Plan G covers far more than one medication, and replacing it later may require medical underwriting.
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Compare the Full Coverage Picture Before Switching Plans. Medicare Advantage plans have their own cost-sharing, networks, and prior-authorization rules. Weigh those terms against Original Medicare and Medigap before making a move that may be difficult to reverse.
The Round 3 announcement is a rare piece of Medicare news whose main action item is patience. The beneficiary paying thousands in Part B coinsurance now has a date circled: January 1, 2028. The number worth watching comes first, when CMS publishes the negotiated prices by November 30, 2026.
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