Overview
- The new prices cover 15 Part D drugs across diabetes, cancer, respiratory disease and other conditions, and they take effect on January 1, 2027.
- CMS estimates roughly $12 billion in program savings and $685 million in enrollee out‑of‑pocket savings in 2027, though some reports cite an $8.5 billion figure based on a different comparison.
- Semaglutide products Ozempic and Rybelsus were set at about $274 for a 30‑day supply and higher‑dose Wegovy at $385, which is above a separate voluntary $245 deal announced for GLP‑1s outside the IRA process.
- The 15 medicines accounted for about $42.5 billion in gross Part D spending in 2024 and were used by approximately 5.3 million enrollees.
- Manufacturers face penalties or withdrawal from Medicare if they reject the negotiated prices, and industry legal challenges to the program have so far been unsuccessful.