Medicare Part D · plan year 2027 · read 2026-11-06
Medicare Part D in 2027: what changes on January 1
The Part D out-of-pocket threshold goes from $2,100 in 2026 to $2,400 in 2027, and the standard deductible from $615 to $700 (CMS, Table V-2).
Medicare's negotiated prices also change that day: 10 of the first ten drugs get a second price, and 15 drugs start their negotiated price. Our arithmetic on the CMS prices: every one of the 10 second prices is up 2.7%.
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Negotiated prices that change on January 1, 2027
10 drugs from the first cycle have a second price that CMS lists as effective January 1, 2027. The difference is our arithmetic on the two CMS prices.
| Drug | Ingredient | Price before | Price from Jan 1, 2027 | Change | CMS update label |
|---|---|---|---|---|---|
| Eliquis with Eliquis Sprinkle | Apixaban | $231.00 effective 2026-01-01 | $237.25 | up $6.25 (+2.7%) | Inflation |
| Enbrel | Etanercept | $2,355.00 effective 2026-01-01 | $2,418.70 | up $63.70 (+2.7%) | Inflation |
| Entresto with Entresto Sprinkle | Valsartan / Sacubitrilat | $295.00 effective 2026-06-01 | $302.98 | up $7.98 (+2.7%) | Deselect |
| Farxiga | Dapagliflozin | $178.50 effective 2026-01-01 | $183.33 | up $4.83 (+2.7%) | Inflation |
| Imbruvica | Ibrutinib | $9,319.00 effective 2026-01-01 | $9,571.07 | up $252.07 (+2.7%) | Inflation |
| Januvia | Sitagliptin | $113.00 effective 2026-01-01 | $116.06 | up $3.06 (+2.7%) | Inflation |
| Jardiance | Empagliflozin | $197.00 effective 2026-01-01 | $202.33 | up $5.33 (+2.7%) | Inflation |
| Novolog with Novolog Flexpen, Novolog Penfill, Fiasp, Fiasp Flextouch and Fiasp Penfill | Insulin Aspart, Human | $119.00 effective 2026-01-01 | $122.22 | up $3.22 (+2.7%) | Deselect |
| Stelara | Ustekinumab | $4,695.00 effective 2026-01-01 | $4,822.00 | up $127.00 (+2.7%) | Deselect |
| Xarelto | Rivaroxaban | $197.00 effective 2026-01-01 | $202.33 | up $5.33 (+2.7%) | Deselect |
New negotiated prices starting January 1, 2027
15 drugs from the second cycle. CMS lists one price for a 30-day supply.
| Drug | Ingredient | Price for a 30-day supply | Effective |
|---|---|---|---|
| Austedo with Austedo XR | Deutetrabenazine | $4,093.00 | January 1, 2027 |
| Breo Ellipta | Fluticasone; Vilanterol | $67.00 | January 1, 2027 |
| Calquence | Acalabrutinib | $8,600.00 | January 1, 2027 |
| Ibrance | Palbociclib | $7,871.00 | January 1, 2027 |
| Janumet with Janumet XR | Metformin; Sitagliptin | $80.00 | January 1, 2027 |
| Linzess | Linaclotide | $136.00 | January 1, 2027 |
| Ofev | Nintedanib | $6,350.00 | January 1, 2027 |
| Otezla with Otezla XR | Apremilast | $1,650.00 | January 1, 2027 |
| Ozempic with Rybelsus and Wegovy | Semaglutide | $274.00 | January 1, 2027 |
| Pomalyst | Pomalidomide | $8,650.00 | January 1, 2027 |
| Tradjenta | Linagliptin | $78.00 | January 1, 2027 |
| Trelegy Ellipta | Fluticasone; Umeclidinium; Vilanterol | $175.00 | January 1, 2027 |
| Vraylar | Cariprazine | $770.00 | January 1, 2027 |
| Xifaxan | Rifaximin | $1,000.00 | January 1, 2027 |
| Xtandi | Enzalutamide | $7,004.00 | January 1, 2027 |
Selected for 2028
CMS has selected 14 more drugs for prices effective January 1, 2028. No price is published yet, so none is shown: Anoro Ellipta, Biktarvy, Cimzia, Cosentyx, Entyvio, Erleada, Kisqali, Lenvima, Orencia, Rexulti, Trulicity, Verzenio, Xeljanz and Xolair.
Sources and data
Part D parameters: CMS announcement of 2026-04-06, Attachment V, Table V-2, page 95; file hash 8bb37a0969062c57. Negotiated prices: CMS negotiated prices page. Edition 2026-11, root 006ab9a329709cbe. The same facts as data: medicare-2027-changes.json. See the licence page. Charitable funds by condition: copay help by condition.
Questions
What is the Part D out-of-pocket threshold for 2027?
CMS prints $2,400 for 2027 and $2,100 for 2026 in Table V-2 of its CY 2027 Rate Announcement (page 95). It is a benefit parameter of the standard Part D benefit. It applies to covered drugs under plan rules and is not a prediction of what any one person will pay.
Which drugs have a negotiated price change on January 1, 2027?
10 of the first ten negotiated drugs have a second price effective January 1, 2027, and 15 drugs from the second cycle start that day. The tables on this page list each, with the price CMS gives for a 30-day supply.
Is a negotiated price what I will pay?
No. It is the price CMS lists for the drug. What you pay depends on your plan, its formulary and your cost sharing.
Where do these figures come from?
The threshold and deductible are from CMS's announcement dated 2026-04-06. The negotiated prices are from CMS's negotiated prices page, read 2026-11-06. Edition 2026-11, root 006ab9a329709cbe.