Medicare’s negotiated price for the blockbuster semaglutide drugs will fall to $274 for a 30-day supply in 2027, a 71 percent cut from a list price near $959. The figure applies to Ozempic, Novo Nordisk’s diabetes version of semaglutide, while the higher-dose Wegovy used for weight and cardiovascular indications carries a separate negotiated price of $385. Both numbers take effect January 1, 2027, and both come from the same federal drug-price negotiation program, but the $274 headline number is a program price, not a guaranteed copay.
What the $274 price covers
The price is a maximum fair price set through Medicare’s drug-price negotiation, the program created by the 2022 Inflation Reduction Act that lets the government negotiate prices on selected high-spending drugs. Semaglutide was among the second round of drugs selected, and its negotiated 30-day price of $274 replaces a list price of roughly $959, the drop that produces the 71 percent reduction.
The Centers for Medicare and Medicaid Services published the results as part of its negotiated prices for selected drugs, which take effect at the start of 2027. The negotiated figure is what Medicare and its drug plans will pay for the medication, and it sets the baseline from which a plan calculates any cost-sharing an enrollee owes.
Semaglutide’s inclusion is notable because the drug ranks among the largest sources of Medicare drug spending. A 71 percent cut on a product used by a large and growing number of beneficiaries represents one of the more consequential outcomes of the negotiation program to date, both for the program’s costs and for the plans that build formularies around it.
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Why Ozempic and Wegovy carry different numbers
Ozempic and Wegovy are both semaglutide made by Novo Nordisk, but they are marketed and dosed differently, which is why one negotiated price does not cover both. Ozempic is the diabetes formulation, and its 30-day negotiated price is the $274 figure. Wegovy is the higher-dose version approved for weight management and cardiovascular risk reduction, and it is priced at $385 for a 30-day supply.
Reporting on the negotiation results notes that the semaglutide products landed at those separate prices alongside other drugs in the same round. The gap between $274 and $385 reflects the dosing and indication differences, not two unrelated negotiations, since both trace back to the same active ingredient and the same manufacturer.
The distinction matters for anyone reading the headline number as a single figure. The 71 percent cut is anchored to the Ozempic price against its former list price; Wegovy’s reduction is measured against its own higher list price. Framing the two together captures the scale of the change while keeping the specific numbers accurate to each product.
What Medicare enrollees will actually pay
The negotiated price is not the same as an enrollee’s out-of-pocket cost. What a beneficiary pays at the pharmacy still depends on the drug plan’s cost-sharing design and on where the person sits in the Part D benefit for the year. The negotiated price lowers the underlying cost that plans work from, which can pull copays and coinsurance down, but it does not set a fixed patient price.
A separate protection caps total spending. Medicare’s annual out-of-pocket limit for Part D drugs holds a beneficiary’s yearly drug costs to $2,000, so no enrollee pays more than that ceiling across all covered medications in a year, regardless of a single drug’s price. For a high-cost drug like semaglutide, that cap already shapes what many members pay more than any one negotiated figure does.
Coverage also depends on the approved use. Medicare drug plans cover Ozempic for diabetes and can cover Wegovy for its approved cardiovascular indication, but federal law restricts Part D coverage of drugs used solely for weight loss. A beneficiary’s access therefore turns on the medical reason for the prescription, which the Centers for Medicare and Medicaid Services and individual plans apply through coverage rules.
The 2027 prices are the second wave of the negotiation program. A first set of negotiated prices for ten drugs takes effect in 2026, and semaglutide sits among a larger group selected for 2027, with further rounds scheduled in later years. Each round targets some of the highest-spending drugs that lack generic or biosimilar competition, and the negotiated prices apply only to Medicare, not to commercial insurance or cash-paying patients. That limit is why the $274 figure describes what the Medicare program secures rather than a new national price for the drug.
For patients outside Medicare, the list price and their own insurer’s terms still govern what they pay, which is why the same medication can cost one amount for a Medicare enrollee and a very different one elsewhere. The negotiation reshapes Medicare’s costs specifically, and the savings move through the program and the drug plans that serve its enrollees.
The $274 price is best read as a signal of how much the negotiation program can move spending on a single high-volume drug, effective at the start of 2027. It cuts what Medicare pays for semaglutide by nearly three-quarters, but the number an individual sees at the counter will still run through a plan’s cost-sharing and the annual out-of-pocket cap, and it will depend on which semaglutide product and which indication is involved.
This article was produced with AI assistance and reviewed by The Money Overview editorial team.
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