Help paying · Medicare negotiated price · pharmacy cost · cycle 2027
Xifaxan (rifaximin): where help paying exists, what Medicare negotiated and what pharmacies pay
Medicare's negotiated price for a 30-day supply is $1,000 on January 1, 2027. ClinicalTrials.gov lists 24 recruiting trials that name rifaximin.
Every package we can price
Per-unit prices (per unit, as the files state). "Scheduled" is a price the CMS file already dates for the future.
| NDC | Product | Unit | Negotiated now | Scheduled | NADAC | Share |
|---|---|---|---|---|---|---|
| 65649-0301-03 | XIFAXAN | n/a | n/a | $3.93 | n/a | no NADAC price |
| 65649-0301-04 | (name not listed) | n/a | n/a | $3.93 | n/a | no NADAC price |
| 65649-0301-05 | (name not listed) | n/a | n/a | $3.93 | n/a | no NADAC price |
| 65649-0301-41 | XIFAXAN | n/a | n/a | $3.93 | n/a | no NADAC price |
| 65649-0302-03 | (name not listed) | n/a | n/a | $20.20 | n/a | no NADAC price |
| 65649-0303-02 | XIFAXAN 550 TABS | n/a | n/a | $20.20 | n/a | no NADAC price |
| 65649-0303-03 | XIFAXAN 550 TABS HUD | n/a | n/a | $20.20 | n/a | no NADAC price |
| 65649-0303-04 | Xifaxan IBS-D 550mg 42ct Blister Pack | n/a | n/a | $20.20 | n/a | no NADAC price |
When could a generic arrive
Each date below is an upper bound from listed patent and exclusivity dates, not a forecast of when a generic will launch. Basis: latest of all listed patent and exclusivity expiries in this Orange Book edition; an upper bound from listed dates only, not a forecast of launch (litigation, settlements, delisting, tentative approvals and 180-day status are not modelled).
| Application | Product | Latest listed patent expiry | Latest listed exclusivity expiry | Latest of the two | Set by |
|---|---|---|---|---|---|
| NDA021361 | Xifaxan, Xifaxan 550 Tabs, Xifaxan 550 Tabs Hud | October 2, 2029 | none listed | October 2, 2029 | patent 8642573; 25 dated entries listed |
Source: FDA Orange Book data files, edition September 2026, read November 7, 2026; patent listings are as submitted by applicants and not verified by FDA. FDA data file.
Medicare Part D spending
CMS's Medicare Part D spending dataset reports gross spending on Xifaxan of $1.16 billion in 2024, across 416,690 claims and 104,805 beneficiaries. CMS's dataset states spending is gross drug cost and does not reflect manufacturers' rebates or other price concessions. Spending is the total paid by Medicare, plans and beneficiaries for the drug's claims, not what a patient pays.
| Year | Gross spending | Claims | Beneficiaries | Average spending per claim |
|---|---|---|---|---|
| 2024 | $1.16 billion | 416,690 | 104,805 | $2,779 |
| 2023 | $1.09 billion | 384,018 | 96,011 | $2,839 |
| 2022 | $969.54 million | 360,882 | 88,758 | $2,687 |
| 2021 | $890.30 million | 357,681 | 87,233 | $2,489 |
| 2020 | $844.56 million | 360,725 | 83,804 | $2,341 |
Source: CMS Medicare Part D spending by drug (data-year-2024, modified 2026-06-25), read November 7, 2026. CMS dataset page. All manufacturers combined; the figures are a drug-level aggregate of claims and say nothing about a formulary or coverage.
Rare-disease (orphan) designations
The FDA's orphan drug database lists 2 designations for Rifaximin; rifaximin, 1 with an approval recorded. A designation is not an approval and not a statement that the drug treats the condition; the status column is the database's own.
| Designated | Designated use | Status | Sponsor |
|---|---|---|---|
| October 28, 2020 | treatment of sickle cell disease | Designated | Salix Pharmaceuticals, Inc. (a division of Bausch Health US, LLC) |
| February 10, 1998 | Treatment of hepatic encephalopathy | Designated/Approved | Salix Pharmaceuticals, Inc. |
Source: FDA Orphan Drug Designations and Approvals database, read November 7, 2026. FDA orphan drug search.
Medicaid use by state
CMS's State Drug Utilization Data records, for 2024, how many prescriptions each state's Medicaid program paid for under this drug's packages and what it reimbursed. The 10 states with the largest reimbursement are shown of 51 with data. Reimbursement is before the rebates manufacturers pay states, so it is not a net cost and not a price a patient pays.
| State | Medicaid-paid prescriptions | Medicaid reimbursed | Covers |
|---|---|---|---|
| CA | 21,801 | $64,213,622 | Fee-for-service only |
| NY | 14,909 | $41,907,052 | All record types |
| OH | 7,677 | $19,658,806 | All record types |
| PA | 6,538 | $17,124,230 | All record types |
| AZ | 5,557 | $15,297,086 | Fee-for-service only |
| KY | 6,524 | $14,747,442 | All record types |
| IL | 5,566 | $13,604,628 | All record types |
| MI | 4,934 | $12,998,612 | All record types |
| WI | 4,392 | $12,158,895 | All record types |
| MA | 4,807 | $12,142,153 | Fee-for-service only |
Where the publisher suppresses small managed-care cells, a state's figure covers fee-for-service claims only and understates use (12 state and package figures are marked that way here). A state missing from the table means its figures were suppressed or not reported, not zero use.
Source: CMS State Drug Utilization Data (State Drug Utilization Data 2024, modified 2026-07-13T15:37:28Z), read November 7, 2026. CMS dataset page. State-reported data compiled by CMS; aggregate by state and package, no provider or patient data.
Where help paying exists
No program in our finder currently lists this drug as open to new patients.
Label changes
The FDA file lists no non-manufacturing label change for these applications since November 11, 2025. The most recent one it lists is dated October 19, 2023 (Labeling).
Source: FDA Drugs@FDA data file, read November 7, 2026. Dates are the FDA action dates; the documents are on FDA's own site. FDA data file. All recent changes across these drugs: label changes feed.
Clinical trials recruiting
ClinicalTrials.gov lists 24 interventional trials that name rifaximin and are recruiting, and 12 more not yet recruiting. By phase: Phase 4: 5, Phase 2: 5, Not applicable: 5, Early phase 1: 3, Phase 3: 2, PHASE2/PHASE3: 2, PHASE1/PHASE2: 1, Phase 1: 1. The 10 most recently updated are below. A listing is not an offer of free drug and not medical advice. Whether a trial fits is decided by the study team and your own clinician.
| Trial | Title and conditions | Phase | Lead sponsor | Last updated | Countries |
|---|---|---|---|---|---|
| NCT06312683 | Rifaximin for the Secondary Prevention of Recurrent PouchitisPouchitis | Phase 4 | University of North Carolina, Chapel Hill | October 23, 2026 | United States |
| NCT07209371 | Rifaximin Versus No Intervention for the Treatment of IgG/IgA (Non-IgM) Monoclonal Gammopathy of Undetermined SignificanceIgA Monoclonal Gammopathy of Undetermined Significance; Non-IgM Monoclonal Gammopathy of Undetermined Significance | Phase 2 | Fred Hutchinson Cancer Center | August 17, 2026 | United States |
| NCT07285785 | Rifaximin 200 mg Plus Oral Rehydration vs Oral Rehydration Alone in Children With Acute DiarrheaDiarrhea; Gastroenteritis; Bacterial Infection | Phase 4 | Bausch Health Americas, Inc. | August 13, 2026 | United States |
| NCT06443502 | A Study to Learn About the Safety of Vedolizumab and How Well it Works in Children and Teenagers With Active Chronic PouchitisPouchitis | Phase 3 | Takeda | August 3, 2026 | Belgium, Croatia, Czechia and 5 more |
| NCT07683936 | Fecal Microbiota Transplantation for the Treatment of Refractory Hepatic Encephalopathy After TIPS SurgeryHepatic Encephalopathy; Fecal Microbiota Transplantation; TIPS | Early phase 1 | Air Force Military Medical University, China | July 6, 2026 | China |
| NCT07635394 | Efficacy of Pregabalin for Patients With Irritable Bowel SyndromeIrritable Bowel Syndrome (IBS) | Not applicable | Beijing Tiantan Hospital | June 25, 2026 | China |
| NCT06727422 | Efficacy of Rifaximin With NAC in IBS-DIBS (Irritable Bowel Syndrome); IBS-D (Diarrhea-predominant) | Phase 2 | Mark Pimentel, MD | April 20, 2026 | United States |
| NCT06718686 | Rifaximin SSD in Dementia TrialDementia Alzheimer Type; Dementia Associated With Cerebrovascular Disease | Phase 1 / Phase 2 | Jasmohan Bajaj | April 3, 2026 | United States |
| NCT07381257 | Efficacy and Safety of Rifaximin-α in Treating MASLDMetabolic Dysfunction-Associated Steatotic Liver Disease | Early phase 1 | Shanghai Changzheng Hospital | February 2, 2026 | China |
| NCT07185932 | Efficacy and Safety of Rifaximin in Treating MAFLDMetabolic-associated Fatty Liver Disease | Early phase 1 | Shanghai Changzheng Hospital | September 22, 2025 | China |
Source: ClinicalTrials.gov, registry data processed November 6, 2026, summarized and trimmed by OmniRx. Search on ClinicalTrials.gov.
Questions
What is the Medicare negotiated price of Xifaxan?
The CMS file publishes $1,000 from January 1, 2027. This is a price CMS agreed with the manufacturer for Medicare Part D, not what a person pays at the counter.
How does the negotiated price compare with what pharmacies pay?
The two CMS files do not give a comparable per-unit price for this drug.
Is there help paying for Xifaxan?
No program in our finder lists this drug yet.
When could a generic version of Xifaxan arrive?
For Xifaxan, the FDA's Orange Book (edition September 2026) lists these latest patent or exclusivity expiry dates by application: NDA021361, October 2, 2029. Each date is an upper bound from listed patent and exclusivity dates, not a forecast of when a generic will launch. Basis: latest of all listed patent and exclusivity expiries in this Orange Book edition; an upper bound from listed dates only, not a forecast of launch (litigation, settlements, delisting, tentative approvals and 180-day status are not modelled).
Can I join a clinical trial for Xifaxan?
ClinicalTrials.gov lists 24 recruiting interventional trials that name rifaximin (registry data processed November 6, 2026). A listing is not an offer of free drug and not medical advice. Whether a trial fits is decided by the study team and your own clinician.
How much does Medicare Part D spend on Xifaxan?
CMS's Medicare Part D spending dataset reports gross spending on Xifaxan of $1.16 billion in 2024, across 416,690 claims and 104,805 beneficiaries. CMS's dataset states spending is gross drug cost and does not reflect manufacturers' rebates or other price concessions. Spending is the total paid by Medicare, plans and beneficiaries for the drug's claims, not what a patient pays.
For developers: this drug as data
One call returns price, generic-entry upper bound, label history, recalls, trials, assistance, and where facts exist the FDA safety program (REMS), DEA schedule, orphan designations, safety notices and Medicaid use by state, each with receipts.
Example file: https://omnirx.org/api/v1/dossier/xifaxan.json
The licence page sets out what a data licence covers, and the API page documents these files.
Evaluation files with receipts; contract may change; not clinical advice.
Sources and terms. CMS Medicare Drug Price Negotiation Program data file (read November 6, 2026; the CMS page states no licence or restriction); CMS NADAC from data.medicaid.gov under the labels in the OmniRx licence ledger; program details read from each program's own pages; CMS Medicare Part D spending by drug; FDA Drugs@FDA and Orange Book data files; ClinicalTrials.gov registry data. Figures are stored with their sources in the OmniRx library (edition 2026-11). Free to cite with attribution. Not medical, legal or financial advice. Report an error through the contact page. Licence the data.