On January 1, 2027, Medicare's negotiated prices take effect for 15 more Part D drugs: Ozempic, Rybelsus and Wegovy (counted as one drug), Trelegy Ellipta, Xtandi, Pomalyst, Ofev, Ibrance, Linzess, Calquence, Austedo, Breo Ellipta, Xifaxan, Vraylar, Tradjenta, Janumet and Otezla. The Centers for Medicare & Medicaid Services (CMS) says the new prices are 38% to 85% below each drug's 2024 list price. Semaglutide (Ozempic, Rybelsus, Wegovy) drops to $274 for a 30-day supply, down from a $959 list price. The negotiated price is what your plan and pharmacy pay. What you pay at the counter depends on your Part D plan, which is why the open enrollment window that ends December 7, 2026 is the time to check.
Every figure below comes from CMS's official fact sheet on the 2027 negotiated prices and its Maximum Fair Price data file, last updated November 2, 2026.
The 15 drugs and their 2027 Medicare prices
The law calls these "maximum fair prices." All prices are for a 30-day supply. The list price is the drug's 2024 wholesale price, which CMS uses as the starting point for comparison.
| Drug | Commonly treats | 2024 list price (30 days) | 2027 Medicare negotiated price (30 days) | Discount |
|---|
| Ozempic; Rybelsus; Wegovy | Type 2 diabetes; heart disease with obesity or overweight | $959 | $274 | 71% |
| Trelegy Ellipta | Asthma; COPD | $654 | $175 | 73% |
| Xtandi | Prostate cancer | $13,480 | $7,004 | 48% |
| Pomalyst | Multiple myeloma; Kaposi sarcoma | $21,744 | $8,650 | 60% |
| Ofev | Idiopathic pulmonary fibrosis | $12,622 | $6,350 | 50% |
| Ibrance | Breast cancer | $15,741 | $7,871 | 50% |
| Linzess | Chronic constipation; IBS with constipation | $539 | $136 | 75% |
| Calquence | Chronic lymphocytic leukemia; mantle cell lymphoma | $14,228 | $8,600 | 40% |
| Austedo; Austedo XR | Huntington's chorea; tardive dyskinesia | $6,623 | $4,093 | 38% |
| Breo Ellipta | Asthma; COPD | $397 | $67 | 83% |
| Xifaxan | Hepatic encephalopathy; IBS with diarrhea | $2,696 | $1,000 | 63% |
| Vraylar | Bipolar I disorder; depression; schizophrenia | $1,376 | $770 | 44% |
| Tradjenta | Type 2 diabetes | $488 | $78 | 84% |
| Janumet; Janumet XR | Type 2 diabetes | $526 | $80 | 85% |
| Otezla; Otezla XR | Plaque psoriasis; psoriatic arthritis; Behçet's oral ulcers | $4,722 | $1,650 | 65% |
Source: CMS, "Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2027," and the CMS Maximum Fair Price data file (November 2, 2026).
The biggest cuts are on the diabetes and lung drugs: Janumet (85%), Tradjenta (84%) and Breo Ellipta (83%). The smallest are on Austedo (38%) and Calquence (40%).
Ozempic, Wegovy and Rybelsus in 2027
CMS treats the three semaglutide brands as one drug with one price: $274 for a 30-day supply. The CMS fact sheet also gives the price for specific packages:
| Package | 2027 Medicare negotiated price |
|---|
| Ozempic 4 mg/3 mL pen, 1 pen | $276.78 |
| Rybelsus 7 mg, 30 tablets | $276.78 |
| Wegovy 2.4 mg/0.75 mL pen, 4 pens | $385.63 |
Two things the price does not change. First, Part D plans still do not cover these drugs for weight loss alone. Ozempic and Rybelsus are covered for type 2 diabetes, and Wegovy for uses such as lowering heart attack and stroke risk in people with heart disease and obesity or overweight. Second, the negotiated price applies only when your Part D plan covers the drug for you.
For weight loss, Medicare runs a separate temporary program, the Medicare GLP-1 Bridge, which started July 1, 2026 and runs through December 31, 2027. It charges a flat $50 copay for a one-month supply of Wegovy (injection or tablet), Foundayo tablets, or the Zepbound KwikPen. You must be 18 or older, have Part D, and meet a body mass index rule (for example, a BMI of 35 or higher). People with type 2 diabetes, moderate to severe sleep apnea or fatty liver disease are not eligible for the Bridge, because their own Part D plan may cover a GLP-1. The $50 does not count toward your Part D deductible or the yearly out-of-pocket cap, and Extra Help does not lower it.
How much will you actually save?
That depends on how your plan charges for the drug.
- If your plan charges coinsurance (a percentage of the drug's price), your share shrinks along with the price. In the standard Part D design, you pay 25% after the deductible. 25% of $175 for Trelegy is $43.75 a month. 25% of $654 would be $163.50.
- If your plan charges a flat copay (say $47 for a preferred brand), the negotiated price may not change what you pay at the pharmacy. It lowers what the plan pays, which can show up in premiums instead.
- If you take a very expensive drug, the 2027 out-of-pocket cap matters more than the discount. Part D spending on covered drugs is capped at $2,400 for 2027, up from $2,100 in 2026. At $7,004 a month, an Xtandi patient reaches the cap early in the year either way.
CMS estimates people with Part D will save about $685 million in out-of-pocket costs in 2027 from these 15 prices under the standard benefit design. If the prices had been in effect in 2024, Medicare would have saved an estimated $12 billion, about 44% less net spending on these drugs. In 2024, about 5.3 million of the 53 million people with Part D used at least one of them.
The law also requires every Part D plan, including Medicare Advantage plans with drug coverage, to include the negotiated drugs on its formulary. A plan can still place a drug on a higher tier or require prior authorization, so check how each plan covers yours.
The first 10 drugs: what happens in 2027
The first round of negotiated prices started January 1, 2026. In 2027, six of those drugs keep a negotiated price, raised for inflation as the law requires. Four leave the program at the end of 2026.
| Drug | 2026 negotiated price (30 days) | 2027 negotiated price (30 days) |
|---|
| Eliquis | $231.00 | $237.25 |
| Jardiance | $197.00 | $202.33 |
| Farxiga | $178.50 | $183.33 |
| Januvia | $113.00 | $116.06 |
| Enbrel | $2,355.00 | $2,418.70 |
| Imbruvica | $9,319.00 | $9,571.07 |
| Xarelto | $197.00 | Removed from the program January 1, 2027 |
| Entresto | $295.00 | Removed from the program January 1, 2027 |
| Stelara | $4,695.00 | Removed from the program January 1, 2027 |
| NovoLog; Fiasp | $119.00 | Removed from the program January 1, 2027 |
Source: CMS Maximum Fair Price data file (November 2, 2026) and CMS's list of drugs with deselection determinations.
CMS removes a drug from the program in certain cases, for example when a generic or biosimilar version comes to market. Once Xarelto, Entresto, Stelara and NovoLog or Fiasp are removed, their price under your plan is set the usual way again, by the plan's own deal with the drug maker. If you take one of them, look closely at its 2027 cost under each plan you compare.
So in 2027, 21 drugs have a Medicare negotiated price: the 15 new ones plus the 6 that remain from round one.
How to check your 2027 cost before December 7
Medicare open enrollment runs October 15 to December 7, 2026. Changes you make take effect January 1, 2027, the same day the new prices start.
- Make a list of your drugs. Write down each drug name, strength, and how often you take it. Note whether any are on the tables above.
- Read your plan's Annual Notice of Change. Your plan mailed it by September 30. It shows your 2027 premium, deductible, and the tier for each drug.
- Use Medicare's Plan Finder. Go to medicare.gov/plan-compare, enter your drugs and pharmacy, and compare estimated 2027 yearly costs across plans. The estimate includes premiums, the deductible and your drug costs.
- Look at the tier and cost type for each negotiated drug. A drug with a 25% coinsurance passes the lower price on to you. A flat copay may not.
- Check for prior authorization or step therapy. These rules can still apply to negotiated drugs.
- Call for free help. Your State Health Insurance Assistance Program (SHIP) gives free, unbiased plan counseling. You can also call 1-800-MEDICARE (1-800-633-4227).
For a full walk-through of comparing plans, see our guide to Medicare Part D plans for 2027. For the deductible, cap and premium changes, see Medicare Part D 2027 costs and the out-of-pocket cap. For background on how the negotiation program works, CoveredUSA has an explainer on the Medicare Drug Price Negotiation Program.
Other 2027 Part D numbers to know
| Part D figure | 2026 | 2027 |
|---|
| Out-of-pocket cap on covered drugs | $2,100 | $2,400 |
| Maximum deductible | $615 | $700 |
| Extra Help copay, generic (100% to 150% of poverty) | $5.10 | $5.80 |
| Extra Help copay, brand (100% to 150% of poverty) | $12.65 | $14.40 |
Premiums do not count toward the out-of-pocket cap. If you get Extra Help, your copays for the drugs above are already low and set by those figures, so the negotiated prices mostly lower Medicare's cost rather than yours.
You can also spread your drug costs across the year with the Medicare Prescription Payment Plan. It does not lower what you owe, but it turns a large January bill into monthly payments. Ask your plan to sign you up.
What comes next: the 2028 drugs
CMS picked 15 more drugs in January 2026 for the third round, the first to include drugs covered under Part B as well as Part D. The list includes Trulicity, Biktarvy, Xolair, Verzenio, Kisqali, Cosentyx and Entyvio, among others. Negotiations happen during 2026, and any negotiated prices take effect January 1, 2028. CMS has not published those prices yet. They do not affect what you pay in 2027.
Frequently Asked Questions
When do the 2027 Medicare negotiated drug prices start?
January 1, 2027. They apply to prescriptions filled on or after that date for people with Part D coverage, through a stand-alone drug plan or a Medicare Advantage plan with drug coverage.
What is the Medicare price for Ozempic in 2027?
$274 for a 30-day supply, down from a $959 list price in 2024, a 71% cut. The same $274 price covers Rybelsus and Wegovy. A single Ozempic 4 mg pen is priced at $276.78.
Will my copay go down in 2027?
Maybe. If your plan charges coinsurance, a percentage of a lower price means a lower bill. If your plan charges a flat copay, your cost may stay the same. Check each plan's 2027 cost for your drug in Medicare's Plan Finder.
Does Medicare cover Wegovy or Ozempic for weight loss in 2027?
Not through regular Part D coverage. Part D covers Ozempic for type 2 diabetes and Wegovy for certain heart-related uses. For weight loss, the Medicare GLP-1 Bridge charges $50 a month for Wegovy, Foundayo or the Zepbound KwikPen through December 31, 2027, for people 18 and older with Part D who meet its body mass index rules and do not have type 2 diabetes.
Do I need to sign up to get the negotiated prices?
No. If you have Part D and your plan covers the drug, the negotiated price applies automatically. Your plan must include the negotiated drugs on its formulary.
How many drugs have Medicare negotiated prices in 2027?
Twenty-one: the 15 new drugs plus 6 from the first round (Eliquis, Jardiance, Farxiga, Januvia, Enbrel and Imbruvica). Xarelto, Entresto, Stelara and NovoLog or Fiasp leave the program on January 1, 2027.
Do the negotiated prices change each year?
Yes. After a drug's first year, CMS raises its negotiated price each year by inflation (the Consumer Price Index). For example, Eliquis goes from $231.00 in 2026 to $237.25 in 2027.
Is the negotiated price what I pay at the pharmacy?
No. It is the most Medicare plans and pharmacies pay for the drug. Your own cost is set by your plan's deductible, tier and copay or coinsurance, and is capped at $2,400 for 2027.
