Medicare's negotiated prices for 15 drugs take effect on 1 January, semaglutide at $274 a month

The Centers for Medicare & Medicaid Services announced the prices on 25 November 2025, in the second round of the Medicare Drug Price Negotiation Program created by the Inflation Reduction Act of 2022. The 15 drugs accounted for $42.5 billion, or 15%, of total Part D spending in 2024, NBC News reported. About 5.3 million of the 53 million people enrolled in Part D used at least one of them that year. The agency projects about $685 million in lower out-of-pocket costs in 2027 under the standard Part D benefit.

From 2006 until 2022, federal law barred Medicare from negotiating drug prices directly with manufacturers. Drugmakers must honor the resulting maximum fair prices for people with Medicare drug coverage and for the pharmacies that fill their prescriptions.

Semaglutide, sold as Ozempic, Wegovy and Rybelsus, is $274 for a 30-day supply, 71% below the $959 list price. Trelegy Ellipta falls to $175 from $654, and Xtandi to $7,004 from $13,480. Ibrance falls to $7,871 from $15,741, Linzess to $136 from $539, and Janumet and Janumet XR to $80 from $526, according to the CMS list as published by NBC News. Measured against 2024 list prices, the 15 prices run from 38% to 85% lower, Quartz reported. Prices vary by package: CMS lists $276.78 for a single Ozempic 4 mg/3 mL pen and $385 for higher doses of Wegovy. The list reaches past the GLP-1 drugs: two GSK inhalers, two older diabetes pills, four cancer drugs, and treatments for lung scarring, psoriasis, schizophrenia, constipation, a liver-related brain disorder and involuntary movement conditions.

The $274 is not the copay

The negotiated price is what Medicare pays drugmakers. It is not what patients pay at the counter. Part D plans must carry the selected drugs on their formularies, but they still set tiers, copays or coinsurance, prior authorization and step therapy.

A 68-year-old with type 2 diabetes should not expect her pharmacy bill to fall by the same 71%, 24/7 Wall St noted. Plan design decides how much of the cut reaches the counter. For the first-round drugs in 2026, coinsurance predominated: it applied in 74% of Medicare Advantage drug plans and 93% of stand-alone Part D plans, according to a research letter in Annals of Internal Medicine. Where coinsurance applies, the out-of-pocket cost moves with the negotiated price. Where a flat copay applies, it does not. CMS has said the first round of 10 drugs, in effect since 1 January 2026, would have saved Medicare $6 billion, or about 22%, had the prices applied in 2023.

Federal law also bars Part D from paying for drugs used for weight loss. The cut does not widen coverage.

What Medicare saves

Had the new prices applied in 2024, CMS estimates Medicare would have spent about $12 billion less on the 15 drugs after rebates, a 44% saving. A second CMS calculation puts the figure at about $8.5 billion, or 36%, once an older manufacturer discount program is included. Both figures use 2024 volumes. Brookings estimates the saving at $12.5 billion, close to the CMS figure. "The price negotiations look very reasonable to me," said Stacie Dusetzina, a health policy professor at Vanderbilt University. "It should hopefully provide some relief for taxpayers and beneficiaries in the long run."

Semaglutide is the biggest line in the round. About 2.3 million Part D enrollees used one of the three brands in 2024, and Part D spent about $15.2 billion on them before rebates.

What else changes in 2027

The prices land inside a benefit that is also moving. The Part D annual out-of-pocket limit rises to $2,400 in 2027 from $2,100 in 2026, and the maximum standard deductible rises to $700 from $615. CMS said the national base beneficiary premium will be $41.33 in 2027, up from $38.99 in 2026.

The temporary Part D premium stabilization demonstration ends after 2026. CMS says plan sponsors now have enough experience with the redesigned benefit to set their own prices without the extra federal support. A separate Medicare GLP-1 Bridge charges a flat $50 a month for Wegovy and some other weight-management drugs outside the standard Part D benefit. Those payments do not count toward the $2,400 cap.

What happens next

Open enrollment runs through 7 December 2026, the window to check how a 2027 plan handles each drug. Beneficiaries who do nothing keep their current plan into 2027, but the Annual Notice of Change lists any new tier, copay, prior-approval rule or step-therapy requirement.

For 2028, up to 15 Part D or Part B drugs will be selected for negotiation, and up to 20 for 2029 and later years, AARP reported. The first round of 10 drugs is expected to save enrollees $1.5 billion in out-of-pocket costs in 2026.