Ozempic and Wegovy in line for Medicare price negotiations
The drugs are among those the Medicare health programme spends the most on for people aged 65 years and older or with disabilities
17 January 2025 - 15:22
byMichael Erman, Ahmed Aboulenein and Bhanvi Satija
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Boxes of Ozempic and Wegovy. Picture: Hollie Adams
Washington, US — Novo Nordisk’s blockbuster diabetes drug Ozempic and weight-loss treatment Wegovy are among the 15 drugs targeted for Medicare price negotiations for 2027, the US government said on Friday.
Other drugs on the list include Pfizer’s cancer drugs Ibrance and Xtandi, GSK’s asthma and chronic obstructive pulmonary disease (COPD) treatment Trelegy Ellipta, Teva’s Huntington’s disease treatment Austedo and Abbvie’s irritable bowel syndrome drug Linzess.
The drugs are among those that the Medicare health programme spends the most on for people aged 65 years and older or with disabilities.
Makers of the selected drugs will have until February 28 to decide if they will participate in the negotiations.
The price negotiation process was established under President Joe Biden’s signature Inflation Reduction Act in 2022. The 15 new drugs are the second group of medications set to undergo the process.
Last year, the US government negotiated price cuts that ranged from 38% to 79% for 10 highly popular prescription drugs used by Medicare, which will be effective in 2026.
“These 15 drugs, together with the 10 drugs that Medicare already negotiated, represent about a third of Medicare Part D spending on prescription drugs,” Biden said in a statement.
Biden administration officials said all forms of dosages and strengths of drugs selected for negotiation were included. This means Novo’s blockbuster weight loss drug Wegovy — which is made with the same ingredient as Ozempic — will be included.
Since March, patients who use Wegovy for reasons in addition to weight loss — like reducing the risk of heart attack or stroke — have been covered.
Government researchers predict that the use of diabetes drug Ozempic and Wegovy for weight loss would raise the US deficit over the next 10 years at its current price. Medicare spent over $4.6bn on the drug in 2022. Novo has a list price of about $935 a month while Wegovy has a list price of around $1,350 a month, though the company says it offers discounts.
About 2.3-million Medicare Part D patients used Novo drugs made with semaglutide in the year ended October 2024, the government said. Total gross spending by Medicare part D plans on the drugs topped $14bn.
It is unclear whether the administration of incoming US president Donald Trump, who will take office on Monday, plans to make any changes to the negotiations, or if it even can.
Biden administration officials suggested their successors were unable to do so because the law outlined detailed selection criteria that the Centers for Medicare and Medicaid, the agency implementing the negotiations, had to follow.
Support our award-winning journalism. The Premium package (digital only) is R30 for the first month and thereafter you pay R129 p/m now ad-free for all subscribers.
Ozempic and Wegovy in line for Medicare price negotiations
The drugs are among those the Medicare health programme spends the most on for people aged 65 years and older or with disabilities
Washington, US — Novo Nordisk’s blockbuster diabetes drug Ozempic and weight-loss treatment Wegovy are among the 15 drugs targeted for Medicare price negotiations for 2027, the US government said on Friday.
Other drugs on the list include Pfizer’s cancer drugs Ibrance and Xtandi, GSK’s asthma and chronic obstructive pulmonary disease (COPD) treatment Trelegy Ellipta, Teva’s Huntington’s disease treatment Austedo and Abbvie’s irritable bowel syndrome drug Linzess.
The drugs are among those that the Medicare health programme spends the most on for people aged 65 years and older or with disabilities.
Makers of the selected drugs will have until February 28 to decide if they will participate in the negotiations.
The price negotiation process was established under President Joe Biden’s signature Inflation Reduction Act in 2022. The 15 new drugs are the second group of medications set to undergo the process.
Last year, the US government negotiated price cuts that ranged from 38% to 79% for 10 highly popular prescription drugs used by Medicare, which will be effective in 2026.
“These 15 drugs, together with the 10 drugs that Medicare already negotiated, represent about a third of Medicare Part D spending on prescription drugs,” Biden said in a statement.
Biden administration officials said all forms of dosages and strengths of drugs selected for negotiation were included. This means Novo’s blockbuster weight loss drug Wegovy — which is made with the same ingredient as Ozempic — will be included.
Since March, patients who use Wegovy for reasons in addition to weight loss — like reducing the risk of heart attack or stroke — have been covered.
Government researchers predict that the use of diabetes drug Ozempic and Wegovy for weight loss would raise the US deficit over the next 10 years at its current price. Medicare spent over $4.6bn on the drug in 2022. Novo has a list price of about $935 a month while Wegovy has a list price of around $1,350 a month, though the company says it offers discounts.
About 2.3-million Medicare Part D patients used Novo drugs made with semaglutide in the year ended October 2024, the government said. Total gross spending by Medicare part D plans on the drugs topped $14bn.
It is unclear whether the administration of incoming US president Donald Trump, who will take office on Monday, plans to make any changes to the negotiations, or if it even can.
Biden administration officials suggested their successors were unable to do so because the law outlined detailed selection criteria that the Centers for Medicare and Medicaid, the agency implementing the negotiations, had to follow.
Reuters
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