HIV drug's Medicare costs under negotiation

The federal government is negotiating lower Medicare prices for a popular once-daily pill that treats HIV and prevents infection.

The Centers for Medicare and Medicaid Services said Tuesday it seeks to lower Medicare costs for 16 medications by negotiating with their manufacturers. Among them is Biktarvy, a drug taken after HIV exposure — known as a post-exposure prophylaxis — to prevent HIV infection as well as a treatment for those living with HIV. Gilead Sciences makes it.

Usage of the drug has risen significantly since it was approved by the U.S. Food and Drug Administration in 2018. More than 100,000 Medicare enrollees used Biktarvy between November 2024 and October 2025, according to Medicare officials.

But increased prescription has meant greater cost. The federal government spent more than $3.9 billion on the drug that same year as part of Medicare Part B and D plans. Meanwhile, Biktarvy brought in $13.4 billion for Gilead in 2024, according to Reuters.

The federal government can now negotiate with drugmakers on Medicare prices for higher-cost drugs like Biktarvy, thanks to a provision of former President Joe Biden’s Inflation Reduction Act.

The new negotiations could lower Medicare costs for Biktarvy and several other drugs, including Botox and the diabetes medication Trulicity. Any effect would not be immediate because the negotiations occur in multiple rounds.

New prices secured through the negotiations would take place January 1, 2028, according to the Centers for Medicare and Medicaid Services.

The Inflation Reduction Act passed Congress in 2022 without support from any Republican lawmakers, but Tuesday’s announcement means its drug negotiation provisions are being put to use under President Donald Trump.

Mehmet Oz, the Trump-appointed administrator of the Centers for Medicare and Medicaid Services, said the goal of the new negotiations is to benefit residents.

“For too long, seniors and taxpayers have paid the price for skyrocketing prescription drug costs,” Oz said in Tuesday’s announcement. “This approach delivers real savings while strengthening accountability across the program.”

Lower prices for the first 10 drugs negotiated under the Inflation Reduction Act took effect this year, Reuters previously reported.

This article was written as part of the Future of Queer Media fellowship program at The Advocate, which is underwritten by a generous gift from Morrison Media Group. The program helps support the next generation of LGBTQ+ journalists.