Medicare’s drug price negotiators have pushed the cost of Ozempic, Wegovy and Rybelsus down to roughly $274 for a 30-day supply, a 71% cut from the nearly $959 list price the government used as its starting point for the talks. The reduction is one of 15 new prices the Centers for Medicare & Medicaid Services finalized under the second round of the Inflation Reduction Act’s drug price negotiation program, and it takes effect January 1, 2027. For older Americans managing diabetes, obesity-related heart risk or both on a fixed income, the cut lands on one of the costliest drug classes inside Medicare Part D, and it arrives just as many enrollees are weighing which Part D plan to pick for next year.
How Medicare Arrived at the $274 Price
The Inflation Reduction Act gave Medicare the authority, for the first time in the program’s history, to negotiate directly with drugmakers over what the government pays for a shortlist of the highest-spending medications. Novo Nordisk’s semaglutide line, sold as Ozempic and Rybelsus for type 2 diabetes and as Wegovy for chronic weight management, was selected for the negotiation program’s second cycle because of how much Medicare spends on the drugs and how limited competition remains in the class. CMS lists semaglutide’s new maximum fair price at about $274, down from a list price near $959, a difference the agency itself rounds to a 71% reduction.
That figure is not a rebate applied after the fact or a discount card a pharmacist scans at checkout. It is the ceiling manufacturers are now required to accept from Medicare and Part D plans, replacing the far higher list price plans previously had to negotiate against on their own with comparatively little leverage. The CMS fact sheet on the 2027 negotiated prices lists 14 other medications, including blood thinners, diabetes pills and inhaled respiratory drugs, that received their own negotiated prices in the same round, all of them taking effect on the same January 1, 2027 date alongside the semaglutide cut, part of a schedule CMS set years in advance.
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Why $274 Won’t Be Every Enrollee’s Copay
The negotiated price is what Medicare and Part D plans pay Novo Nordisk, not necessarily what a beneficiary hands over at the pharmacy counter. Actual out-of-pocket cost still depends on which Part D plan a person carries, where they fall inside that plan’s deductible and coverage phases, and how the plan tiers coinsurance for the drug. Coverage for weight-loss use specifically also remains inconsistent, since Medicare has historically excluded drugs prescribed solely for obesity unless a plan covers the same medication for an approved secondary use, such as lowering cardiovascular risk in people who already have heart disease.
One protection does apply to everyone regardless of plan design: the $2,000 annual cap on out-of-pocket prescription costs that already took effect under the same law. Once a Part D enrollee’s own spending on covered drugs reaches that ceiling in a given year, the plan absorbs the remaining cost through December. A lower negotiated price does not guarantee a lower monthly bill for every enrollee, but it does shrink the total drug spending that counts toward the cap, which can help enrollees who use expensive drugs reach that ceiling with less cash out of pocket along the way. Public radio’s coverage of the announcement noted the negotiated price does not, by itself, dictate what any specific enrollee pays at checkout.
A Second Round Signals a Widening Program
This is the second batch of Medicare-negotiated prices to reach beneficiaries, following the first round of ten drugs that took effect earlier in 2026. The program is built to widen its reach with each cycle, adding more high-cost medications to the negotiated list in the years the law remains in place and in force. That structure means retirees managing several chronic conditions at once are increasingly likely to see a negotiated price attached to at least one of their prescriptions in a given year, even when that particular drug was not part of the program’s first round of cuts.
Trade press coverage of the negotiation framed the semaglutide cut as one of the program’s largest percentage reductions so far, reflecting both the drug’s steep list price and the leverage Medicare now holds as the country’s single largest drug purchaser. Novo Nordisk still sets its own list price for cash-paying customers and for commercial insurers, which are not bound by the Medicare-negotiated figure and can continue charging closer to the original list price outside the program.
For the Medicare population specifically, the shift moves a drug class that had been effectively out of reach for many fixed-income enrollees toward one that, combined with the Part D spending cap, is now within reach for a meaningfully larger share of the people prescribed it. Whether that translates into a lower bill at the pharmacy by January 2027 will depend heavily on how individual Part D plans structure their coverage tiers once the new negotiated price takes hold, which is why comparing plans during the fall enrollment window still matters even after the price cut.
This article was researched and drafted with the assistance of artificial intelligence.
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