Medicare sets a $274 negotiated price for Ozempic, Wegovy and Rybelsus starting in 2027

Medicare's negotiated price for semaglutide — the active ingredient in Ozempic, Wegovy and Rybelsus — is $274 for a 30-day supply, down from a list price of about $959, under the second cycle of the Medicare Drug Price Negotiation Program. The price takes effect January 1, 2027 ^[1][2].

What the $274 figure covers

The $274 is a maximum fair price, or MFP. CMS negotiates by ingredient and dosage form rather than by individual brand, which is why one figure applies to all three products even though their FDA labels differ: Ozempic and Rybelsus are approved for type 2 diabetes, while Wegovy is approved for chronic weight management and carries an additional label for reducing cardiovascular risk in adults with heart disease ^[2].

Exact prices vary among packages and strengths. CMS calculated an MFP of $276.78 for one commonly used Ozempic pen ^[1]. The $274 figure is about a 71 percent cut from the $959 reference price Medicare uses to calculate the discount ^[1][2].

Semaglutide is one of 15 drugs in the program's second round, all of which reach their negotiated prices on the same January date ^[2]. Negotiations for this round ran through most of 2025, with CMS locking the final number in December after meetings with Novo Nordisk that the agency is not required to make public ^[2].

Why it matters for patients

The negotiated price is not a copay. It sets what Medicare pays inside the program. A Part D plan still applies its own deductible, tier placement, cost-sharing formula, prior-approval rules and step therapy ^[1]. Plans must put selected drugs with negotiated prices on their formularies, and CMS has said it will review formularies for practices that undermine access, but plans keep considerable control over how that access works ^[1].

How much of the discount reaches a patient depends on how the plan charges. For a beneficiary who has met the deductible and is in the initial coverage phase, the standard 25 percent coinsurance would bring a semaglutide copay from roughly $240 to about $69 a month ^[2]. Where a plan charges a flat copay instead of a percentage, the negotiated price does not automatically change that dollar amount ^[1].

Sources differ on one 2027 figure. One report says annual out-of-pocket spending on covered Part D drugs is capped at $2,400 in 2027 ^[1]; another says CMS finalized a $2,100 threshold ^[2]. Both describe the same tradeoff: a lower per-fill cost can mean a patient reaches the catastrophic phase later, paying less overall but over a longer stretch ^[2].

The maximum Part D deductible rises to $700 in 2027, though individual plans may charge less ^[1].

Wegovy for weight loss follows a separate track. A temporary Medicare program has offered it at a flat $50 monthly copay since July 2026, with eligibility tied to body mass index and other conditions ^[1][2]. That copay does not count toward the Part D out-of-pocket limit, and neither do cash purchases ^[1]. CMS has not indicated the two pricing tracks will merge before the program's scheduled end ^[2].

What happens next

Medicare open enrollment runs October 15 to December 7 ^[1]. The negotiated prices and the $700 deductible take effect January 1, 2027 ^[1][2]. The $50 weight-loss program is currently extended through December 31, 2027; the negotiated price is permanent once it takes effect, subject to adjustments CMS can make in later negotiation cycles ^[1][2]. What individual Part D plans will charge for semaglutide in 2027 has not been published, and that amount will appear in each plan's 2027 materials ^[1].