Novo Nordisk says Ozempic pills reach US pharmacies May 4 at $149 to $299 a month

Novo Nordisk said its Ozempic (semaglutide) tablets will be available in the United States starting Monday, May 4, 2026, for adults with type 2 diabetes, at more than 70,000 pharmacies nationwide ^[1]. The pills come in three strengths: 1.5 mg, 4 mg and 9 mg ^[1].

The company said self-pay patients using NovoCare Pharmacy or select telehealth providers will pay $149 a month for the 1.5 mg starting dose, $199 a month for the 4 mg pills and $299 a month for the 9 mg pills. One month is defined as one bottle of 30 tablets ^[1]. Novo Nordisk said the pill will be covered by insurance for most patients with type 2 diabetes for as little as $25 for up to a three-month prescription. Government beneficiaries are excluded, and eligibility and restrictions apply to that offer ^[1].

A renamed, reformulated Rybelsus

Oral semaglutide for type 2 diabetes was first approved by the FDA in 2019 as Rybelsus tablets in 3 mg, 7 mg and 14 mg strengths ^[1]. Novo Nordisk said those strengths have been reformulated and are now being introduced as Ozempic tablets 1.5 mg, 4 mg and 9 mg, in a smaller pill. The company said the new Ozempic pill works similarly to the original tablets and has the same efficacy and safety profile ^[1].

Rybelsus will continue to be marketed outside the United States ^[1]. Novo Nordisk said Rybelsus patients should continue their medication as directed and speak with their health care professionals about transitioning to the Ozempic pill as appropriate ^[1].

In a statement, Ed Cinca, senior vice president of marketing and patient solutions at Novo Nordisk Inc., said having both an injection and an oral option under one brand lets treatment be individualized ^[1]. David Kayne, MD, a partner at Cedars-Sinai Medical Group in Encino, California, said: "For some people, having a pill option can fit better into their daily routines. While injectable and oral medicines both treat adults with type 2 diabetes, they are not the same" ^[1].

What the label covers

According to the company, the Ozempic pill is the only FDA-approved oral peptide GLP-1 medicine for adults with type 2 diabetes indicated both to improve blood sugar along with diet and exercise and to reduce the risk of major cardiovascular events such as heart attack, stroke or death in patients who are also at high risk for those events ^[1]. Novo Nordisk said it is the only oral GLP-1 approved for both primary and secondary cardiovascular risk reduction in this group ^[1].

Ozempic pills are not approved for use in children, the company said ^[1]. Labeled serious risks include possible thyroid tumors, including cancer; rodent studies showed thyroid tumors with Ozempic and similar medicines, and it is not known whether the drug causes thyroid tumors or medullary thyroid carcinoma in people ^[1]. The most common side effects listed are nausea, vomiting, diarrhea, stomach pain and constipation, plus decreased appetite with the tablets ^[1].

Why it matters for patients

People with type 2 diabetes who prefer not to inject now have a semaglutide pill sold under the same brand name as the injection, which the company said is manufactured end-to-end in the US and is available through NovoCare Pharmacy as well as retail pharmacies ^[1]. The dosing is different from the older oral semaglutide: the strengths change from 3 mg, 7 mg and 14 mg to 1.5 mg, 4 mg and 9 mg, so a prescription written for Rybelsus does not simply carry over at the same number ^[1].

Cost will vary. The listed self-pay prices range from $149 to $299 a month, while the company's insured-patient figure of as little as $25 depends on coverage and eligibility rules that exclude government beneficiaries ^[1]. Novo Nordisk said it reserves the right to modify or cancel that program at any time ^[1].

What happens next

Novo Nordisk said it filed a supplemental drug application earlier this year for Ozempic tablets 25 mg for adults with type 2 diabetes, and it expects an FDA decision by the end of 2026 ^[1]. The tablets were not previously sold under the Ozempic name in the US, so patients filling prescriptions in May may see the Rybelsus name replaced at the pharmacy counter ^[1].

Whether insurers broadly cover the new strengths, and how pharmacy shelves handle the transition from Rybelsus, has not been disclosed beyond the company's own statements ^[1].