The news: The Trump administration released the next 15 drugs slated for Medicare price negotiations, marking the third round of negotiations.

The new list includes a Gilead Sciences' HIV treatment, several cancer drugs, AbbVie’s Botox, and Eli Lilly’s lesser-known GLP-1 drug Trulicity. For the first time, the government included Medicare Part B drugs—administered in doctors’ offices—alongside traditional Part D pharmacy drugs. Prices will be set later and become effective January 1, 2028.

Catch up quick: Drug price negotiations were established under the 2022 Inflation Reduction Act. Prior to that, the US government was prohibited from negotiating prescription drug prices with pharma manufacturers. Earlier this month, lower prices kicked in for the first 10 drugs negotiated in 2024.

Why it matters: The negotiation program lowers Medicare spending on prescription drugs, which we forecast will exceed $438 billion this year across all programs, up about 7% from 2025.

• The new list of drugs accounted for $27 billion in Medicare Part B and D prescription spending between November 2024 and October 2025—about 6% of total Part B and D spend, according to the Centers for Medicare & Medicaid Services (CMS).
• The first round of Biden administration-led negotiations saved Medicare about $6 billion annually on 10 drugs, while the Trump administration recently touted roughly $12 billion in savings from the 15 drugs selected for round 2.
• It’s unclear how much lower prices for the 15 drugs in round 3 will be, though earlier selections saw cuts of 38% to 79%.

The impact on drug manufacturers is considered to be manageable, however.

• Only a small subset of overall products—mostly older medicines—have been selected for price cuts, and many have minimal Medicare exposure.
• For 14 of the 15 drugs in round 3, Medicare revenue subject to negotiation accounts for 0% to 3% of companies’ projected 2027 global sales, per Leerink Partners estimates cited by CNBC.
• Gilead’s prescription HIV pill Biktarvy is the exception: Medicare revenue represents around 8% of the company’s global sales, according to Leerink.

Implications for pharma companies: While drugmakers whose products were chosen for this round shouldn’t expect a big revenue blow, it adds to the drug-pricing headwinds Big Pharma is facing. Many of the medicines chosen for the Medicare program are also produced by companies that are separately cutting prices of other medicines under recent agreements with the Trump administration. The industry strongly opposes the drug pricing negotiation program, and legal challenges so far have failed. But bipartisan support suggests it’s here to stay, forcing Big Pharma to pivot toward driving higher volumes of lower-priced drugs and taking a tougher stance with international governments on pricing.