Fifteen more prescription drugs, including the diabetes and weight-loss medicine Ozempic and the inhaled COPD treatment Trelegy, will carry lower negotiated Medicare prices starting January 1, 2027. The prices are the result of the second round of the Medicare Drug Price Negotiation Program, which lets the government set a maximum fair price for a slate of high-cost medicines covered under Part D. Together with the ten drugs whose negotiated prices took effect at the start of 2026, the new batch brings the total to 25.
The 15 drugs and when the lower prices take effect
The Centers for Medicare and Medicaid Services published the finalized prices for the second cycle on its selected drugs page, confirming that the maximum fair prices go into effect on January 1, 2027. The list runs to fifteen Part D medicines and reaches into some of the most widely used and expensive drug categories in the program, from diabetes and obesity treatments to cancer therapies and respiratory inhalers.
Alongside Ozempic, Rybelsus, and Wegovy, which share a negotiated price as products from the same manufacturer, the list includes the cancer drugs Xtandi, Pomalyst, Ibrance, and Calquence. It also covers the diabetes medicines Tradjenta and Janumet, the lung-disease treatments Trelegy Ellipta, Breo Ellipta, and Ofev, the digestive drugs Linzess and Xifaxan, and the neurology and psychiatry medicines Austedo, Vraylar, and Otezla.
The prices were reached after CMS exchanged offers and counteroffers with each manufacturer through 2026, and every company chose to participate rather than exit the program. The negotiated amount applies to a 30-day equivalent supply and holds for the year, replacing the list-price-driven cost that had governed what plans and beneficiaries paid before.
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How steep the cuts are for Ozempic and the other medicines
The negotiated price for Ozempic, Rybelsus, and Wegovy is $274 for a month’s supply, a fraction of a list price that has run near $959, according to CMS. That single family of drugs accounted for roughly $14.4 billion in gross Medicare drug spending over the measured period, more than any other product on the list, which is part of why its price drew the most attention.
The reductions are not uniform across the list. Each drug was negotiated separately, and the size of the cut reflects the medicine’s spending, the alternatives available, and the data each manufacturer submitted. Trelegy Ellipta, the inhaled COPD and asthma treatment, ranked among the higher-spending drugs on the list at about $5.1 billion, as detailed in the CMS fact sheet on the 2027 prices.
CMS estimates that the second-cycle prices will save Medicare Part D beneficiaries an estimated $685 million in out-of-pocket costs in the first year under the program’s standard benefit design. Those savings sit on top of a separate change that already capped annual out-of-pocket drug spending for Part D enrollees, meaning the two provisions work in tandem to lower what retirees pay at the pharmacy counter.
The drugs did not land on the list at random. Medicare selects negotiation-eligible medicines from those with the highest total Part D spending that have been on the market for years without generic or biosimilar competition, which is why the roster leans toward brand-name drugs taken by large numbers of enrollees over long stretches. That design steers the program toward the medicines whose prices weigh most heavily on Medicare and on the people who fill them month after month.
What the negotiated prices do and don’t change for retirees
The lower prices flow to beneficiaries through their Part D plans, but the exact out-of-pocket effect depends on a person’s plan design and where they land in the year’s coverage phases. A negotiated price reduces the underlying cost that plans and the government share, which can translate into lower coinsurance for enrollees who pay a percentage of a drug’s price rather than a flat copay.
Coverage of a drug is not guaranteed simply because it appears on the negotiated list. Plans still maintain formularies, and a beneficiary whose plan does not cover a listed medicine, or covers a different product in the same class, may not see the negotiated figure at all. The program sets a ceiling price for participating plans rather than forcing every plan to stock every drug on the list, as industry reporting on the 2027 slate has underscored.
Timing also shapes what a beneficiary feels. The negotiated price applies for the full 2027 plan year, but a retiree’s out-of-pocket share still depends on the annual deductible, any coinsurance their plan charges, and the point at which they reach the yearly cap on drug spending. Someone who hits that cap early in the year may notice little further difference, while a beneficiary paying a percentage of a high-cost drug through much of the year stands to feel the reduction most directly.
The larger significance is that the program is now compounding. The first ten drugs took effect in January 2026, these fifteen arrive in January 2027, and a third cycle covering additional medicines is already in negotiation for prices that would begin in 2028. Each round pulls another set of high-cost, widely used drugs under a government-set ceiling, and the running list is becoming a fixed feature of what Part D enrollees can expect to pay year to year.
This article was produced with AI assistance and reviewed against primary sources by The Money Overview editorial team.
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