Direct answer: On January 1, 2027, negotiated prices take effect for 15 Medicare Part D drugs, including Ozempic, Rybelsus, and Wegovy. The negotiated price for a 30-day supply of those three semaglutide drugs is $274, down from a 2024 list price of $959, a 71% reduction, according to the Centers for Medicare & Medicaid Services (CMS), November 2025. CMS projects that people with Medicare drug coverage will save about $685 million in out-of-pocket costs in 2027 under the standard benefit design.
Which drugs get lower prices?
The 15 drugs cover diabetes, asthma, COPD, cancer, psoriasis, and other conditions. About 5.3 million of the 53 million people with Medicare Part D coverage were dispensed one of these drugs in 2024, according to CMS, November 2025.
These 15 drugs accounted for $42.5 billion in total Part D gross covered prescription drug costs in 2024, about 15% of all Part D gross costs. In the same year, people with Part D coverage spent $1.7 billion out of pocket on these drugs, according to CMS, November 2025.
The full list is Ozempic, Rybelsus, and Wegovy (one selected drug), Trelegy Ellipta, Xtandi, Pomalyst, Ofev, Ibrance, Linzess, Calquence, Austedo and Austedo XR, Breo Ellipta, Xifaxan, Vraylar, Tradjenta, Janumet and Janumet XR, and Otezla and Otezla XR, according to CMS, November 2025.
How much does each drug cost now?
The table below shows the negotiated price, called the maximum fair price, for a 30-day supply, next to the 2024 list price. All figures come from CMS, November 2025.
| Drug | Negotiated price, 2027 | List price, 2024 | Reduction |
|---|---|---|---|
| Ozempic; Rybelsus; Wegovy | $274 | $959 | 71% |
| Trelegy Ellipta | $175 | $654 | 73% |
| Xtandi | $7,004 | $13,480 | 48% |
| Pomalyst | $8,650 | $21,744 | 60% |
| Ofev | $6,350 | $12,622 | 50% |
| Ibrance | $7,871 | $15,741 | 50% |
| Linzess | $136 | $539 | 75% |
| Calquence | $8,600 | $14,228 | 40% |
| Austedo; Austedo XR | $4,093 | $6,623 | 38% |
| Breo Ellipta | $67 | $397 | 83% |
| Xifaxan | $1,000 | $2,696 | 63% |
| Vraylar | $770 | $1,376 | 44% |
| Tradjenta | $78 | $488 | 84% |
| Janumet; Janumet XR | $80 | $526 | 85% |
| Otezla; Otezla XR | $1,650 | $4,722 | 65% |
The largest cut by percentage is Janumet, down 85%. The largest cut in dollars for a widely used drug is semaglutide: $685 less per 30-day supply. Prices vary by dosage form and strength. For example, one Ozempic 4 mg/3 mL pen is $276.78, and four Wegovy 2.4 mg/0.75 mL pens are $385.63, according to CMS, November 2025.
Who qualifies?
The negotiated prices apply to people with Medicare Part D prescription drug coverage who are dispensed one of the 15 selected drugs. The drug company must make the negotiated price available to eligible people and to the pharmacies that dispense the drug, according to CMS, November 2025.
The prices do not apply to people without Medicare drug coverage. They also do not apply to drugs outside the selected list, even if the same company makes them.
Does the negotiated price change what you pay at the pharmacy?
Not directly. The negotiated price is a ceiling on what the manufacturer may charge a Part D plan. Your own share still comes from your plan's deductible, the drug's tier, and its copay or coinsurance.
Two people on the same drug can pay different amounts under different plans. The $685 million in projected savings is a CMS estimate under the standard benefit design, not a promise about any single plan, according to CMS, November 2025.
One related change helps in 2027 regardless of plan: the Part D out-of-pocket cap rises from $2,100 to $2,400, and the maximum standard deductible rises from $615 to $700, according to the CMS 2027 Rate Announcement, April 2026. After you reach the cap, you pay nothing more for covered drugs for the rest of the calendar year, according to Medicare.gov.
When does it start?
The negotiated prices take effect on January 1, 2027. CMS published the prices on November 25, 2025, after the negotiation period ended on November 1, 2025.
Medicare open enrollment runs October 15 to December 7, 2026, and any plan change takes effect January 1, 2027, according to Medicare.gov. Your plan must receive your request by December 7. This is the window to check whether your 2027 plan covers your drugs and what your share will be.
What should you check before December 7?
- Check your plan's 2027 formulary to confirm each of your drugs is still covered, and at which tier.
- Compare your total yearly drug cost, not just the monthly premium, using the Plan Finder at Medicare.gov.
- Read the Annual Notice of Change your plan mailed in September or October for 2027 premium and cost changes.
- Ask your pharmacist or plan whether the negotiated price changes your copay for a drug you take.
- Check Extra Help and Medicare Savings Programs if costs are a burden. Extra Help can be applied for at any time, according to Medicare.gov.
Frequently asked questions
Will Ozempic cost $274 at my pharmacy?
Not necessarily. $274 is the negotiated price for a 30-day supply that caps what the manufacturer charges the plan. Your copay depends on your plan's tier, deductible, and pharmacy. Check your plan's 2027 costs to see your own share.
How much will Medicare save overall?
If the negotiated prices had applied in 2024, they would have saved an estimated $12 billion in net covered prescription drug costs, about 44% lower net spending, according to CMS, November 2025. Including Coverage Gap Discount Program spending, the estimate is about $8.5 billion, about 36% lower.
Are more drugs coming?
Yes. CMS named 15 drugs for the third negotiation cycle on January 27, 2026, plus one drug for renegotiation, with any negotiated prices becoming effective in 2028. Together with the first two rounds, 25 drugs carry a negotiated price, according to CMS.
Do I need to do anything to get the lower price?
No separate application is needed. The drug company must make the negotiated price available to eligible people with Part D coverage and to dispensing pharmacies, according to CMS, November 2025. Your plan still sets your copay, so comparing plans during open enrollment is the step that affects your cost.
What if my plan does not cover my drug in 2027?
A negotiated price does not force a plan to cover a drug. If your drug is not on your plan's formulary, the price does not help you. Use open enrollment, which ends December 7, 2026, to find a plan that covers your medicines.
Key Takeaway
Fifteen Part D drugs, led by Ozempic at $274 instead of $959, get negotiated prices on January 1, 2027, with about $685 million in projected out-of-pocket savings. The price caps what the manufacturer charges, not your copay, so the move that matters now is comparing your 2027 plan before open enrollment ends on December 7, 2026.
Sources: Centers for Medicare & Medicaid Services, “Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2027” (fact sheet, November 2025); CMS, “Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies” (April 6, 2026); Medicare.gov, “Joining a plan” and “How much does Medicare drug coverage cost?”
This post was created with the help of AI tools and reviewed for accuracy against the sources cited above. It is general information only, not medical advice. For decisions about your own medicine or coverage, please talk to your doctor, pharmacist, or a licensed Medicare counselor.



























