Medicare sets $274 price for semaglutide starting in 2027

Medicare has set a maximum price of $274 for a 30-day supply of semaglutide — the drug sold as Ozempic, Rybelsus and Wegovy — starting Jan. 1, 2027. The Centers for Medicare and Medicaid Services announced the figure on Nov. 25, 2025, in the second round of Medicare drug price negotiations. CMS said it is 71% below the $959 list price the agency recorded for 2024 ^[1][2][4].

Semaglutide was the largest selected drug group in Medicare Part D by gross spending, at $15.2 billion in 2024, and about 2.28 million Part D enrollees used it that year, according to CMS ^[1]. The agency lists the conditions it can treat as type 2 diabetes, type 2 diabetes with cardiovascular disease, and cardiovascular disease with obesity or overweight ^[1].

The $274 figure covers a 30-day supply, but the amount varies by dosage form and strength. CMS listed a maximum fair price of $276.78 for a 4 mg/3 mL Ozempic pen, $276.78 for a 30-tablet package of 7 mg Rybelsus, and $385.63 for a package of four 2.4 mg Wegovy pens ^[1][4].

CMS negotiated prices for 15 drugs in this round, including treatments for cancer, asthma and digestive conditions. The agency estimated that if all 15 negotiated prices had been in effect during 2024, Medicare would have saved $12 billion in net covered prescription drug costs, about 44% less in aggregate. Beneficiaries' out-of-pocket spending would have been $685 million lower, CMS said ^[1][2]. For comparison, the first round of negotiations was credited with about $6 billion in savings, or a 22% net reduction ^[4]. The managed care pharmacist group AMCP noted that the savings figures compare 2027 prices with 2024 spending and do not account for changes in net prices between those years ^[4].

The negotiated semaglutide price is not the only one in play. On Nov. 6, 2025, the White House announced a separate agreement with Novo Nordisk, which makes Ozempic, Rybelsus and Wegovy, setting a voluntary price of $245 a month for all forms of semaglutide for Medicare starting in 2026, a year before the negotiated price begins ^[4][5]. NPR reported the difference and quoted Dr. Benjamin Rome of Brigham and Women's Hospital: "It's not clear why Novo [Nordisk] would promise a different price in two different venues." ^[5] Novo Nordisk said it "look[s] forward to additional clarity from CMS on how pricing and coverage will work," and that it remains opposed to government price setting ^[5]. How the $245 and $274 figures will interact has not been explained ^[5]. AARP's chief executive, Dr. Myechia Minter-Jordan, said the negotiated prices "will bring meaningful relief to millions of people on Medicare" ^[5].

Why it matters for patients

The negotiated price applies to Medicare Part D, which covered about 53 million people in 2024 ^[1]. Part D enrollees who take Ozempic, Rybelsus or Wegovy are the group most directly affected. What any one person pays at the pharmacy depends on their plan, its formulary and the pharmacy, and CMS has not said how individual copays will be set ^[1]. People with commercial insurance or no insurance are not covered by this price.

An analysis in Health Affairs noted that for the drugs in this round that fall in Medicare's "protected classes," patient cost sharing has often been a percentage of list price, so a lower negotiated price can also lower what patients pay at the counter ^[3]. Semaglutide was not among the five protected-class drugs in this cycle ^[3]. Since 2025, Part D enrollees have also had a $2,000 annual cap on out-of-pocket drug spending ^[3].

What happens next

• Jan. 1, 2026: Negotiated prices for the first 10 drugs in the program take effect ^[4].
• By Feb. 1, 2026: CMS is scheduled to announce 15 more Part B or Part D drugs whose negotiated prices would start in 2028 ^[4].
• By Nov. 30, 2026: CMS is scheduled to publish those prices ^[4].
• Jan. 1, 2027: The $274 semaglutide price and the other 14 negotiated prices take effect ^[1][4].

Whether the two semaglutide prices announced by the government will be reconciled, and how Medicare coverage of these drugs may change, has not been reported.