15 Medicare Drug Prices Changing in 2027: Ozempic, Wegovy, Trelegy and More
15 Medicare Drug Prices Changing in 2027: Ozempic, Wegovy, Trelegy and More
Millions of Medicare beneficiaries could see lower prices on some of the program’s most expensive prescription drugs beginning in 2027.
The Centers for Medicare & Medicaid Services (CMS) has negotiated prices for 15 high-cost Medicare Part D drugs, including medications used for diabetes, obesity, cancer, asthma, COPD and other chronic conditions.
The negotiated prices take effect on:
January 1, 2027
The list includes several widely used drugs, including:
- Ozempic;
- Rybelsus;
- Wegovy;
- Trelegy Ellipta;
- Linzess;
- Tradjenta;
- Janumet;
- Xtandi;
- Ibrance;
- and others.
CMS says approximately 5.3 million people with Medicare Part D coverage used these 15 drugs during 2024.
Together, the medications accounted for approximately $42.5 billion in gross Medicare Part D prescription drug costs that year.
CMS estimates that if the negotiated prices had been in effect during 2024, Medicare’s net spending on the drugs would have been approximately $12 billion lower, representing about 44% lower net spending in aggregate under CMS’s stated comparison methodology.
For beneficiaries, CMS estimates the negotiated prices could produce approximately $685 million in out-of-pocket savings in 2027 under the defined-standard Part D benefit design.
Here is the complete 2027 Medicare negotiated drug-price list and what beneficiaries should understand before assuming the negotiated price is the amount they will personally pay at the pharmacy.
Medicare Negotiated Drug Prices for 2027 at a Glance
CMS publishes the negotiated amount as a Maximum Fair Price, or MFP.
The prices below represent CMS’s negotiated price for a 30-day equivalent supply and are compared with the drugs’ 2024 list prices used by CMS.
| Drug | 2027 negotiated price | 2024 list price | CMS-listed discount |
|---|---|---|---|
| Ozempic, Rybelsus, Wegovy | $274 | $959 | 71% |
| Trelegy Ellipta | $175 | $654 | 73% |
| Xtandi | $7,004 | $13,480 | 48% |
| Pomalyst | $8,650 | $21,744 | 60% |
| Ofev | $6,350 | $12,622 | 50% |
| Ibrance | $7,871 | $15,741 | 50% |
| Linzess | $136 | $539 | 75% |
| Calquence | $8,600 | $14,228 | 40% |
| Austedo / Austedo XR | $4,093 | $6,623 | 38% |
| Breo Ellipta | $67 | $397 | 83% |
| Xifaxan | $1,000 | $2,696 | 63% |
| Vraylar | $770 | $1,376 | 44% |
| Tradjenta | $78 | $488 | 84% |
| Janumet / Janumet XR | $80 | $526 | 85% |
| Otezla / Otezla XR | $1,650 | $4,722 | 65% |
These figures come from the CMS fact sheet on negotiated prices for 2027.
Important note about the prices
The figures above should not be interpreted as the exact copay every Medicare beneficiary will pay.
The negotiated price is the price Medicare requires participating manufacturers to make available under the Medicare Drug Price Negotiation Program.
A beneficiary’s actual pharmacy cost can depend on:
- the specific Part D plan;
- deductible status;
- the drug’s formulary tier;
- coinsurance or copayment rules;
- whether the pharmacy is in-network;
- other Part D benefit rules; and
- how much the beneficiary has already spent during the year.
CMS also calculates negotiated prices across different dosage forms, strengths and package sizes.
For example, the CMS 30-day-equivalent negotiated price for the Ozempic/Rybelsus/Wegovy selected drug group is $274, but individual package-level maximum fair prices can differ based on the dosage form and quantity.
When Do the New Medicare Drug Prices Start?
The negotiated prices become effective:
January 1, 2027
CMS says manufacturers participating in the program must make the negotiated prices available for eligible Medicare beneficiaries and the pharmacies, mail-order services and other entities that dispense the selected drugs.
Medicare prescription drug plans are also required to include selected drugs with agreed negotiated prices on their formularies, subject to Medicare’s program rules.
You can review the current official list through the CMS Selected Drugs and Negotiated Prices page.
Ozempic, Rybelsus and Wegovy Medicare Price in 2027
One of the most closely watched negotiations involves Novo Nordisk’s semaglutide products:
- Ozempic
- Rybelsus
- Wegovy
CMS grouped these products as one selected drug for purposes of the negotiation program.
The negotiated price for a 30-day equivalent supply is:
$274
CMS’s corresponding 2024 list-price comparison was:
$959
That represents a CMS-listed discount of:
71%
According to CMS, approximately 2.282 million Medicare Part D beneficiaries used these medications during 2024.
They also represented approximately:
$15.16 billion in gross Medicare Part D spending
during that year.
That made the semaglutide group the highest-spending drug selection in the 2027 negotiation cycle.
Does this mean every Medicare member can get Wegovy for $274?
No.
The $274 amount is CMS’s negotiated 30-day-equivalent price, not a universal retail price or beneficiary copayment.
CMS provides package-specific pricing examples showing that different package sizes or dosage forms can have different maximum fair prices.
Whether a particular beneficiary receives coverage for Ozempic, Rybelsus or Wegovy also depends on Medicare coverage rules, the drug’s FDA-approved use, and the person’s Part D plan.
Trelegy Ellipta Price Falls to $175 in CMS Comparison
Trelegy Ellipta is used to treat respiratory conditions including asthma and chronic obstructive pulmonary disease, or COPD.
CMS negotiated a 2027 30-day-equivalent price of:
$175
The 2024 list price used for comparison was:
$654
CMS lists the resulting discount at:
73%
Approximately 1.269 million Medicare Part D enrollees used Trelegy Ellipta during 2024, according to CMS.
The drug accounted for approximately:
$5.30 billion
in gross Part D prescription drug costs.
Breo Ellipta Gets One of the Largest Percentage Reductions
Breo Ellipta is another inhaled medication used for asthma and COPD.
CMS negotiated a 2027 price of:
$67
compared with a 2024 list price of:
$397
That represents a CMS-listed discount of:
83%
Approximately 626,000 Medicare Part D beneficiaries used Breo Ellipta during 2024.
Janumet Has the Largest Listed Percentage Discount
Among the 15 negotiated drugs, Janumet and Janumet XR receive the largest percentage reduction compared with the 2024 list price used by CMS.
Negotiated 2027 price:
$80
2024 list price:
$526
CMS-listed discount:
85%
Janumet is used for the treatment of type 2 diabetes.
Approximately 239,000 Medicare Part D beneficiaries used Janumet or Janumet XR during 2024.
Tradjenta Medicare Price Drops to $78
Tradjenta is another medicine used to treat type 2 diabetes.
CMS negotiated a 2027 price of:
$78
compared with the 2024 list price of:
$488
CMS lists the discount at:
84%
Approximately 274,000 Medicare Part D enrollees used Tradjenta during 2024.
Linzess Negotiated Price Falls to $136
Linzess is used for conditions including chronic idiopathic constipation and irritable bowel syndrome with constipation.
CMS negotiated a 2027 price of:
$136
compared with a 2024 list price of:
$539
The CMS-listed reduction is:
75%
Approximately 632,000 Medicare Part D beneficiaries used Linzess during 2024.
That makes it one of the more widely used drugs on the 2027 negotiation list.
Cancer Drugs Are Also Included
Several of the selected medications are expensive cancer treatments.
These include:
Xtandi
Used for prostate cancer.
2027 negotiated price: $7,004
2024 list price: $13,480
Discount: 48%
Pomalyst
Used for conditions including multiple myeloma and Kaposi sarcoma.
2027 negotiated price: $8,650
2024 list price: $21,744
Discount: 60%
Ibrance
Used for breast cancer.
2027 negotiated price: $7,871
2024 list price: $15,741
Discount: 50%
Calquence
Used for certain blood cancers, including chronic lymphocytic leukemia and mantle cell lymphoma.
2027 negotiated price: $8,600
2024 list price: $14,228
Discount: 40%
The dollar amounts remain high because these medications have high underlying prices.
Again, a negotiated price is not necessarily the amount a beneficiary pays personally.
Individual cost sharing depends on Part D plan rules and where the beneficiary is within the prescription drug benefit during the year.
Other Drugs With Negotiated Medicare Prices in 2027
Ofev
Used for idiopathic pulmonary fibrosis.
Negotiated price: $6,350
2024 list price: $12,622
Discount: 50%
Austedo and Austedo XR
Used for Huntington’s disease chorea and tardive dyskinesia.
Negotiated price: $4,093
2024 list price: $6,623
Discount: 38%
This is the smallest percentage reduction among the 15 drugs, according to the CMS comparison.
Xifaxan
Used for conditions including hepatic encephalopathy and irritable bowel syndrome with diarrhea.
Negotiated price: $1,000
2024 list price: $2,696
Discount: 63%
Vraylar
Used for conditions including bipolar I disorder, major depressive disorder and schizophrenia.
Negotiated price: $770
2024 list price: $1,376
Discount: 44%
Otezla and Otezla XR
Used for conditions including plaque psoriasis, psoriatic arthritis and oral ulcers associated with Behçet’s disease.
Negotiated price: $1,650
2024 list price: $4,722
Discount: 65%
How Much Will Medicare Save From the 2027 Drug Prices?
CMS estimates that the negotiated prices could produce substantial savings for both Medicare and beneficiaries.
The agency says approximately 5.3 million people with Medicare Part D coverage used these 15 drugs in 2024.
The selected drugs accounted for:
$42.5 billion
in gross Part D prescription drug costs during 2024.
That represented approximately:
15% of total Medicare Part D gross covered prescription drug costs
for the year.
CMS estimates that if the negotiated prices had been in effect during 2024, they would have reduced net Medicare spending by approximately:
$12 billion
or about:
44%
in aggregate under CMS’s comparison excluding Coverage Gap Discount Program spending.
When CMS includes the Coverage Gap Discount Program in the comparison, it estimates approximately:
$8.5 billion
in savings, or about:
36% lower aggregate net spending.
These are retrospective estimates based on 2024 utilization and spending—not a guarantee of exactly how much Medicare will save in 2027.
How Much Could Medicare Beneficiaries Save?
CMS estimates people enrolled in Medicare prescription drug coverage could collectively save approximately:
$685 million in out-of-pocket costs in 2027
under the defined-standard benefit design as a result of the negotiated prices.
But that does not mean every person using one of the drugs will receive the same percentage reduction in their copay.
An individual’s savings depend on factors such as:
- the Part D plan;
- whether a deductible applies;
- coinsurance;
- other plan cost sharing;
- pharmacy choice;
- drug dosage;
- package size;
- and total prescription drug spending during the year.
This distinction is especially important when headlines compare the negotiated price with a manufacturer’s list price.
A beneficiary may not have been paying the full list price before negotiation.
Therefore:
A 71% reduction from list price does not automatically mean a beneficiary’s personal pharmacy bill falls by 71%.
What Is a Medicare “Maximum Fair Price”?
Under the Medicare Drug Price Negotiation Program, the negotiated price is referred to in federal law as a:
Maximum Fair Price, or MFP.
CMS negotiates this amount with participating manufacturers for selected high-spending drugs that meet statutory eligibility requirements.
The negotiated price acts as the applicable maximum negotiated amount that must be made available under the program for eligible Medicare beneficiaries.
CMS says it considered several factors during negotiations, including:
- available therapeutic alternatives;
- comparative effectiveness;
- research and development costs;
- federal financial support;
- manufacturing and distribution costs;
- revenue and sales information;
- patents and market exclusivity; and
- unmet medical needs.
CMS also held negotiation meetings with manufacturers before reaching the final prices.
Why Were These 15 Drugs Selected?
The Medicare Drug Price Negotiation Program focuses on certain high-expenditure drugs without generic or biosimilar competition that meet federal eligibility requirements.
For the second negotiation cycle, CMS selected 15 drugs covered under Medicare Part D.
The drugs were among the program’s highest-spending eligible medications.
The list includes treatments for:
- diabetes;
- obesity and cardiovascular disease;
- asthma;
- COPD;
- prostate cancer;
- breast cancer;
- blood cancers;
- pulmonary fibrosis;
- gastrointestinal conditions;
- movement disorders;
- mental health conditions; and
- inflammatory diseases.
The negotiated prices become effective in 2027.
Do All Medicare Part D Plans Have to Cover These Drugs?
CMS states that Medicare prescription drug plans, including stand-alone Part D plans and Medicare Advantage plans with drug coverage, must include selected drugs for which CMS and the participating manufacturer have agreed to a negotiated price on their formularies, subject to applicable Medicare rules.
CMS says it will use its formulary review process to assess practices that could undermine beneficiary access to selected drugs.
However, formulary placement does not mean every drug will have identical cost sharing in every plan.
Beneficiaries should review their plan’s 2027 formulary and cost-sharing information during Medicare Open Enrollment.
Medicare Open Enrollment Matters for These Drugs
Medicare Open Enrollment runs from:
October 15 through December 7, 2026
This gives beneficiaries an opportunity to compare prescription drug coverage for 2027.
Someone taking one of the newly negotiated drugs should check:
- whether their plan covers the medication;
- the drug’s formulary tier;
- deductible rules;
- coinsurance or copayments;
- prior authorization requirements;
- preferred pharmacies; and
- estimated yearly drug costs.
A negotiated drug price can lower underlying costs, but Part D plans can still differ in how costs are structured for beneficiaries.
How Drug Costs Fit Into the Bigger 2027 Retirement Picture
Prescription costs are only one part of the financial changes Medicare beneficiaries may face in 2027.
Retirees are also watching Social Security COLA changes and other Medicare expenses.
For the broader retirement-benefit picture, see our guide to 2027 Social Security Benefit Changes: COLA, Retirement Age and New Limits.
You can also estimate how a future COLA could affect your monthly benefit with our Social Security COLA 2027 Calculator.
For a closer look at the inflation formula behind the adjustment, read How Social Security COLA Is Calculated Using CPI-W.
Understanding both income and health-care expenses can give retirees a more complete picture than looking at either Social Security or Medicare in isolation.
Frequently Asked Questions
Which Medicare drug prices are changing in 2027?
CMS negotiated prices for 15 selected Medicare Part D drugs, including Ozempic, Rybelsus, Wegovy, Trelegy Ellipta, Xtandi, Pomalyst, Ofev, Ibrance, Linzess, Calquence, Austedo, Breo Ellipta, Xifaxan, Vraylar, Tradjenta, Janumet and Otezla product groups.
Some products are grouped together as a single selected drug under Medicare’s negotiation rules.
When do the 2027 negotiated Medicare drug prices begin?
The negotiated prices take effect January 1, 2027.
What is the Medicare negotiated price for Ozempic in 2027?
CMS lists a $274 negotiated price for a 30-day equivalent supply for the selected Ozempic/Rybelsus/Wegovy group.
Package-specific maximum fair prices can differ based on dosage form and quantity.
What is the Medicare price for Wegovy in 2027?
Wegovy is part of the same semaglutide selected-drug group as Ozempic and Rybelsus.
CMS lists a $274 negotiated 30-day-equivalent price for the selected drug group, but the agency’s package-level examples show that actual MFPs can differ by package and dosage form.
Does this mean Medicare beneficiaries will pay $274 for Ozempic?
Not necessarily.
The maximum fair price is not the same thing as every beneficiary’s copay.
Actual out-of-pocket costs depend on the Part D plan, deductible, cost-sharing structure and other benefit rules.
Which drug has the biggest percentage discount?
In CMS’s comparison with 2024 list prices, Janumet and Janumet XR have the largest listed reduction at 85%.
Tradjenta follows at 84%, and Breo Ellipta at 83%.
How much will beneficiaries save in 2027?
CMS estimates the negotiated prices could save Medicare Part D beneficiaries about $685 million in collective out-of-pocket costs in 2027 under the defined-standard benefit design.
Individual savings vary.
How many Medicare beneficiaries use the 15 drugs?
CMS says approximately 5.3 million Part D beneficiaries used the selected drugs during 2024.
Are the negotiated prices the same as drug list prices?
No.
The negotiated maximum fair prices are prices established through the Medicare Drug Price Negotiation Program.
CMS compared those prices with 2024 Wholesale Acquisition Cost list prices when calculating the published percentage reductions.
Can the negotiated prices change later?
CMS says negotiated prices can be adjusted in later years according to applicable program rules, including inflation adjustments.
A drug can also cease to be a selected drug under certain circumstances, such as qualifying generic or biosimilar competition entering the market.
Bottom Line
Fifteen major Medicare Part D drugs will have negotiated prices beginning January 1, 2027.
The list includes widely used medications such as:
Ozempic, Rybelsus, Wegovy, Trelegy Ellipta, Linzess, Tradjenta, Janumet and Breo Ellipta, along with several high-cost cancer and specialty drugs.
CMS’s published discounts compared with 2024 list prices range from:
38% to 85%
The largest listed percentage reductions include:
Janumet — 85%
Tradjenta — 84%
Breo Ellipta — 83%
Linzess — 75%
Trelegy Ellipta — 73%
Ozempic/Rybelsus/Wegovy — 71%
CMS estimates the 15 negotiated prices could save Medicare beneficiaries approximately $685 million in out-of-pocket costs during 2027 under the defined-standard Part D benefit design.
However, the negotiated price is not automatically the amount an individual beneficiary will pay at the pharmacy.
Actual costs depend on the person’s Part D plan, deductible, cost-sharing rules, pharmacy, dosage and overall prescription spending.
Beneficiaries taking one of the selected medications should therefore compare their 2027 plan options carefully during Medicare Open Enrollment rather than assuming the published negotiated price will equal their final copay.
Related Reading on Elite Era Trends
2027 Social Security Benefit Changes: COLA, Retirement Age and New Limits
Social Security COLA 2027 Calculator: Estimate Your New Monthly Check
Social Security Benefit Increase Projection 2027
How Is Social Security COLA Calculated? CPI-W Formula and 2027 Estimate
