CMS negotiates a 70% discount for Ozempic and Wegovy

CMS has negotiated a 71% discount off the list price, or $274 for a 30-day supply, on Novo Nordisk’s semaglutide products — Ozempic and Rybelsus for diabetes and Wegovy for weight loss — through the Inflation Reduction Act’s (IRA) Medicare price negotiation program for Part D.

CMS has released the prices for the second set of drugs chosen as part of the program. The new prices for these 15 drugs will become effective Jan. 1, 2027. (See table below.) The 15 drugs in this second cycle are used to treat cancer, diabetes, asthma, and other chronic illnesses.

CMS says these 15 drugs represent some of the highest Medicare Part D spending. CMS officials say had these new prices been in effect in 2024, Medicare would have saved about $12 billion and beneficiaries would have had $685 million in out-of-pocket costs.

Between Jan. 1, 2024, and Dec. 31, 2024, these 15 drugs accounted for $42.5 billion in total Part D gross covered prescription drug costs, or about 15% of total Part D gross covered prescription drug costs during 2024. In 2024, about 5.3 million people with Part D coverage took these drugs. During that same time period, people with Medicare Part D prescription drug coverage spent $1.7 billion out of pocket for these drugs selected for negotiation.

The projected savings CMS was able to negotiate vary from 38% for Austedo and Austedo XR (deutetrabenazine), which treats chorea (involuntary movements) in Huntington’s disease and tardive dyskinesia, to 85% off the list price for Janumet and Janumet XR, which is a combination of sitagliptin and metformin to treat people with diabetes. In 2024, Medicare Part D’s total prescription spending for Austedo was $1.68 billion. For Janumet, 2024 spending was $1.07 billion.

Medicare was able to negotiate a savings of 50% on two other high-spending Medicare products. Ibrance (palbociclib), which is used to treat patients with advanced or metastatic breast cancer, cost Medicare Part D $2.04 billion in 2024. Ofev (nintedanib), which is used to treat patients with idiopathic pulmonary fibrosis, cost the program $2.09 billion in 2024.

What’s next?

Beginning in January 2026, first the prices for the first 10 negotiated Medicare Part D drug prices take effect. When they were announced in August 2024, the negotiated discounts for the first 10 drugs ranged from 38% to 79% off list prices, CMS said. Officials estimated had the negotiated prices been in effect, they would have saved an estimated $6 billion in net covered prescription drug costs, or approximately 22%, across the 10 selected drugs.

By February 2026, CMS will choose 15 therapies for negotiation that can be Part D or Part B drugs, with new prices to take effect in 2028.