Medicare drug price negotiation 2029: CMS final rule locks in 20-drug cycle

CMS published final rule 2026-22792 codifying the Medicare Drug Price Negotiation Program on Nov 9, 2026; it is effective Dec 5, 2026. The rule governs the program from initial price applicability year 2029, capping that cycle at up to 20 selected drugs. First hard outputs: a selected-drug list due Feb 1, 2027 and maximum fair prices due Nov 30, 2027. A Temporary Floor for Small Biotech Drugs (Sec. 429.440) is the provision most directly priced in the biotech complex; XBI traded at 155.92, up 2.44 percent, on the session. The 2026, 2027 and 2028 cycles stay under earlier guidance and are not superseded by this rule. The Department of Health and Human Services, through the Centers for Medicar…