U.S. names HIV, arthritis drugs for next Medicare price talks

The U.S. government on Tuesday named the 15 newdrugstargeted forMedicarepricenegotiations for 2028, including Gilead Sciences’HIVdrug Biktarvy and Pfizer’sarthritistreatment Xeljanz.

It is the third round ofdrugssubject to former President Joe Biden’s Inflation Reduction Act of 2022, which allowed the government to negotiateprices of somedrugspurchased by the U.S.Medicarehealth program for people aged 65 and older or with disabilities.

Despite the industry’s longstanding opposition to the law and multiple failed lawsuits, the first negotiatedprices on 10drugssold in pharmacies went into effect this year.

The 2028 list also includes products that are administered in doctors’ offices or hospitals, such as Novartispsoriasis drug Cosentyx and Botox, which is made by AbbVie.

Other medications up for negotiation include Eli Lilly’sGLP-1 diabetes drug Trulicity.

“With prior rounds of pricing negotiations reasonable, and several of these medicines set to lose exclusivity in the near-term, we continue to expect that the impacts will be manageable,” said BMO Capital Markets analyst Evan Seigerman.

The U.S.Medicarehealth plan said last year that theprices it had negotiated for 15drugsstarting in 2027 would save the program 36% on those medications compared with recent annual spending, or about $8.5 billion.

Shares of Gilead, Lilly, AbbVie, Johnson & Johnson, Pfizerand Bristol Myers were all up nearly 2% in after-hours trading.

Gilead’sHIVtreatment Biktarvy, which had 2024 sales of $13.4 billion, had been expected to be on the negotiation list. The company in October said it had reached settlements with three generic manufacturers, extending the drug’s U.S. patent coverage to April 2036.

“While we expect Biktarvy will likely be eligible for IRApricenegotiations beginning in 2028, only a low-20% ofUSsales are expected to be exposed,” JP Morgan said in a research note at that time.

The U.S. Centers for Medicaid andMedicareServices said the selecteddrugsaccounted for $27 billion in spending in the 12 months ended October 31, 2025. Thedrugsare also selected based on being either seven or 11 years out from being approved by the U.S. Food and Drug Administration and for which there is no generic or biosimilar alternative.

Drugmakers have continued to contest the legislation in courts.

“The IRA continues to show  why  government pricesetting is  the wrong approach for Americans,” Elizabeth Carpenter, head of policy and research at trade group PhRMA, said in a statement. “Since the law took effect, seniors have faced higher costs, fewer choices and more barriers to care.”

A Novartis spokesperson said its twodrugs, Cosentyx for inflammatory diseases and Kisqali for breast cancer, bring significant value to patients and that the law allowing negotiation will have long-lasting consequences for patients.