Medicare’s Negotiated Price for Ozempic, Rybelsus and Wegovy Drops to $274 a Month on Jan. 1, One of 15 Drugs CMS Says Will Save Enrollees $685 Million
For a retiree filling a semaglutide prescription every month, the sticker price behind it has been $959. That was the 2024 list price for a 30-day supply of Ozempic, Rybelsus or Wegovy, and on Jan. 1 Medicare’s negotiated price for the same supply falls to $274, according to the Centers for Medicare & Medicaid Services.
The semaglutide drugs are one of 15 medicines in the second round of Medicare drug price negotiation. CMS estimates the new prices will save people in Medicare drug coverage about $685 million in out-of-pocket costs in 2027.
This is the second year the program has touched pharmacy counters. The first 10 negotiated prices took effect in January 2026, and the National Community Pharmacists Association has urged pharmacies to sign up for the CMS system tied to paying for those drugs.
That system is the Medicare Transaction Facilitator, and the pharmacists’ association has told pharmacies to enroll in it as soon as possible. The drugmakers, not the patients, are responsible for making the negotiated price available to the pharmacies and other outlets that dispense these drugs, CMS says.
A 71% Cut on Paper, and 14 Other Drugs Alongside It
CMS lists the semaglutide group at a 71% discount from its list price. The other 14 drugs on the agency’s fact sheet range from a 38% cut to an 85% cut:
- Trelegy Ellipta: $654 to $175
- Xtandi: $13,480 to $7,004
- Pomalyst: $21,744 to $8,650
- Ofev: $12,622 to $6,350
- Ibrance: $15,741 to $7,871
- Linzess: $539 to $136
- Calquence: $14,228 to $8,600
- Austedo and Austedo XR: $6,623 to $4,093
- Breo Ellipta: $397 to $67
- Xifaxan: $2,696 to $1,000
- Vraylar: $1,376 to $770
- Tradjenta: $488 to $78
- Janumet and Janumet XR: $526 to $80
- Otezla and Otezla XR: $4,722 to $1,650
All figures are for a 30-day supply, with list prices from 2024. CMS says about 5.3 million of Part D’s 53 million enrollees used these drugs in 2024 and paid $1.7 billion out of pocket for them. Across the whole group, the agency estimates Medicare’s net spending would have been about 44% lower, roughly $12 billion, had the prices applied in 2024.
CMS Administrator Dr. Mehmet Oz said the round produced “substantially better outcomes for taxpayers and seniors” than earlier deals, Fierce Healthcare reported. Novo Nordisk, which makes the semaglutide drugs, told the outlet it has “serious concerns about the Inflation Reduction Act’s impact on patients.”
Why the Pharmacy Bill Will Not Read $274
The negotiated price is what Medicare drug plans and pharmacies pay for the drug. It is not the enrollee’s copay. What a person actually pays at the counter depends on their plan’s deductible, copays and coinsurance, which is why CMS frames the savings as an estimate under the standard Part D benefit.
The $274 figure also covers three products that come in different forms. Bloomberg Law reported that the price works out to about $276 for Ozempic and Rybelsus and about $385 for Wegovy because of those dosage-form differences.
There is a second price in the picture. The administration announced a separate deal with Novo Nordisk setting a $245 monthly Medicare price for Ozempic and Wegovy. The National Community Pharmacists Association noted that the $274 negotiated price is higher than that deal price. Bloomberg Law reported that experts said it was unclear how the two would interact, while the negotiated price is mandatory for Part D.
Where the $50 GLP-1 Bridge Fits In
Coverage of these drugs for obesity runs through a separate CMS program. KFF reported in April that CMS’s GLP-1 Bridge lets eligible beneficiaries get GLP-1 coverage for obesity with a $50 copay, and that CMS extended it through the end of 2027 because its longer-term BALANCE model will not launch on Jan. 1, 2027 as scheduled. The Bridge originally ran only from July through December 2026.
That means a person using Wegovy for weight in 2027 may be dealing with the Bridge’s flat copay rather than with the negotiated price directly. The two programs run side by side, and the details of each person’s eligibility come from their plan and from Medicare.
For enrollees whose plans already cover semaglutide, the negotiated price works through the plan itself. CMS says every Part D plan and Medicare Advantage drug plan must include the 15 selected drugs on its formulary, and after 2027 each price rises only with inflation unless it is renegotiated.
Other Drug-Cost Changes Arriving the Same Day
The new prices land alongside other Part D shifts. The Associated Press reported on Oct. 15 that the annual out-of-pocket cap on covered drugs rises to $2,400 in 2027, from $2,100, as covered here earlier, and that the standard deductible climbs to $700 from $615, a change detailed in the site’s look at the 2027 Part D deductible.
Advocates for older adults say the cost pressure is real. “Higher healthcare costs are making it harder for older Americans to afford the care they need,” Nancy LeaMond, AARP’s executive vice president and chief advocacy officer, told the AP.
Medicare open enrollment runs through Dec. 7. People who take any of the 15 drugs can use that window to check how each 2027 plan prices them, since two plans paying the same negotiated price can still charge members very different copays.
Get stories like this by email. Sign up for The Parent Diaries Letter.
This article was produced with AI assistance and edited for accuracy against the sources linked above.
Image: HualinXMN – CC BY-SA 4.0/Wikimedia Commons
