The Medicare Drug Price Negotiation Program, established by the Inflation Reduction Act of 2022, allows prices for the most expensive drugs to be negotiated without competition. The first ten selected drugs will have negotiated prices effective from 2026, with minimum discounts of at least 38% from the 2023 price. These prices are expected to save Medicare $6 billion a year and policyholders $1.5 billion in copayments. For four drugs, including etanercept (60% discount) and ibrutinib, palbociclib and enzalutamide (25% discount), the minimum rebates exceed the 2020 rebates, generating savings of $1.8 billion. A second round for 15 drugs, including Ozempic, will begin in 2027 with savings of $8.5 billion. The third round includes 15 high-cost drugs from Part D and for the first time from Part B, with negotiations in 2026 and prices starting in 2028. Each round adds more drugs cumulatively.