Medicare's second negotiation round trims 15 drugs including Ozempic, saving about $685 million

The Centers for Medicare & Medicaid Services has finalized new negotiated prices for a second group of 15 prescription drugs under the Medicare Drug Price Negotiation Program, with the lower prices taking effect January 1, 2027 ^[1]. Novo Nordisk's Ozempic, Wegovy and Rybelsus anchor the list, with a 30-day supply falling to $274 from a list price of $959, a roughly 71 percent cut ^[1][2]. CMS projects the full set of 15 drugs will save Medicare Part D enrollees an estimated $685 million in out-of-pocket costs, on top of the $1.7 billion enrollees already paid for these same drugs in 2024 ^[1].

The second cycle was announced by CMS in late November 2025 and covers roughly 5.3 million people with Part D coverage who filled at least one of the 15 drugs in 2024, generating $42.5 billion in total gross covered drug spending that year ^[1]. Because Ozempic and Rybelsus are approved for type 2 diabetes while Wegovy carries a separate weight-management and cardiovascular-risk label, all three share the same $274 price because CMS negotiates by ingredient and dosage form rather than by brand indication ^[2].

The $274 figure is not automatically what a beneficiary pays at the pharmacy. A person who has already met their annual deductible and sits in the initial coverage phase pays 25 percent coinsurance, which would bring a semaglutide copay down from roughly $240 today to about $69 once the negotiated price applies ^[2]. Medicare Advantage prescription drug plans are bound by the same negotiated price as standalone Part D plans, so enrollees should not need to switch plans to see the lower tier cost in January ^[2].

A separate wrinkle complicates the picture. Around the same time CMS finalized this cycle, the administration struck a "most favored nation" pricing arrangement with Novo Nordisk that set a lower $245 price for the same GLP-1 drugs under Medicare ^[1]. Trade press coverage reported that CMS has indicated the most-favored-nation price is expected to supersede the negotiated price for covered GLP-1 drugs ^[1]. Every other drug on the 15-drug list is governed solely by the negotiation, with no competing federal price to sort out — semaglutide is the exception ^[1]. Separately, since July 2026 a temporary Medicare pilot has offered Wegovy for weight-loss indications at a flat $50 monthly copay tied to BMI and comorbidity criteria, a different pricing track that runs alongside, not instead of, the negotiated price for diabetes use ^[2].

Why it matters for patients

For someone on Medicare taking Ozempic, Rybelsus or Wegovy for an approved use, the practical bottom line is that a lower price is coming, but the exact number is not fully settled. Two federal pricing mechanisms — the negotiated $274 and the separate $245 most-favored-nation deal — now apply to the same drugs, and only one can govern what happens at the pharmacy counter ^[1]. What an individual actually pays also still depends on their specific Part D plan's benefit design and where they sit in the deductible, initial coverage, or catastrophic phase when they fill a prescription ^[1][2]. A lower per-fill price also means it could take longer to reach the $2,100 annual out-of-pocket threshold that triggers full coverage for the rest of the year, though total spending to get there would be lower ^[2]. Someone using Wegovy specifically for weight loss under the separate pilot program pays the flat $50 copay regardless of the negotiated price, so the reason a drug was prescribed can determine which price track applies ^[2].

What happens next

The negotiated $274 price and the other 14 drugs' prices are scheduled to take effect January 1, 2027, and CMS has listed no contingency for delaying that date ^[1][2]. CMS has not published an accounting of how the most-favored-nation arrangement changes its $685 million savings estimate, treating the two initiatives as separate rather than combined ^[1]. The weight-loss pilot offering Wegovy at $50 a month is explicitly temporary and is scheduled to run through December 2027, with no indication yet that it will merge with the standard negotiated price ^[2].