Medicare 2026

What the 15 Newly Negotiated Medicare Drug Prices Mean for 2027 — From Ozempic to Trelegy

Starting January 1, 2027, Medicare's drug price negotiation program expands to a second round of medicines. Fifteen more Part D drugs — treating everything from type 2 diabetes and COPD to several cancers and serious mental health conditions — will have a federally negotiated price, called the "maximum fair price," that drug manufacturers must honor for people with Medicare and the pharmacies that serve them. Here is a plain-English look at what is changing, what is not, and how to think about it as you review your Part D coverage.

The 15 drugs and their 2027 negotiated prices

Each price below is for a 30-day supply, compared with the drug's 2024 list price:

• Ozempic, Rybelsus and Wegovy (semaglutide): $274, vs. list $959
• Trelegy Ellipta (asthma, COPD): $175, vs. $654
• Xtandi (prostate cancer): $7,004, vs. $13,480
• Pomalyst (multiple myeloma, Kaposi sarcoma): $8,650, vs. $21,744
• Ofev (idiopathic pulmonary fibrosis): $6,350, vs. $12,622
• Ibrance (breast cancer): $7,871, vs. $15,741
• Linzess (chronic constipation, IBS-C): $136, vs. $539
• Calquence (chronic lymphocytic leukemia, mantle cell lymphoma): $8,600, vs. $14,228
• Austedo and Austedo XR (Huntington's chorea, tardive dyskinesia): $4,093, vs. $6,623
• Breo Ellipta (asthma, COPD): $67, vs. $397
• Xifaxan (hepatic encephalopathy, IBS-D): $1,000, vs. $2,696
• Vraylar (bipolar I, major depressive disorder, schizophrenia): $770, vs. $1,376
• Tradjenta (type 2 diabetes): $78, vs. $488
• Janumet and Janumet XR (type 2 diabetes): $80, vs. $526
• Otezla (Behcet's oral ulcers, plaque psoriasis, psoriatic arthritis): $1,650, vs. $4,722

CMS estimates these 2027 prices would have saved Medicare roughly $12 billion — about 44 percent — had they been in place in 2024, and projects that people enrolled in Part D will save about $685 million in out-of-pocket costs in 2027.

What a "negotiated price" actually does

It is important to separate program savings from member savings. The maximum fair price is the price a manufacturer must make the drug available at to Medicare enrollees and pharmacies. It is not your copay. What you pay at the pharmacy still depends on:

• whether your plan's deductible applies,
• which tier your plan places the drug on,
• the plan's cost-sharing (copay or coinsurance), and
• where you are in the benefit year relative to the Part D out-of-pocket cap ($2,400 in 2027).

Once your true out-of-pocket spending for covered Part D drugs reaches that annual cap, you pay $0 for covered drugs for the rest of the calendar year. Plans may also offer the Medicare Prescription Payment Plan, which lets you spread covered Part D costs across the year in monthly installments instead of paying the full amount at the pharmacy counter.

A negotiated price stays in effect while the drug remains in the program and is adjusted each year after the first by the change in the Consumer Price Index (CPI-U). CMS publishes the updated figures.

Where the drugs will appear

By law, both stand-alone Part D plans and Medicare Advantage plans that include drug coverage must list every negotiated drug on their formularies. That does not mean every plan handles each drug the same way — tiering, prior authorization and step therapy rules can still differ — but access to the drug itself is required.

How to put this to work during Open Enrollment

Medicare's Annual Enrollment Period for 2027 coverage runs October 15 – December 7, 2026, with new coverage starting January 1, 2027. If you take any of the 15 drugs above (or others you depend on), this is the window to:

1. List your current medications and preferred pharmacy. 2. Use the Plan Finder at Medicare.gov to see how each available Part D or Medicare Advantage drug plan covers them, including tier and any restrictions. 3. Check the plan's deductible (no more than $700 for Part D in 2027) and total projected yearly cost.

Original Medicare + Medigap vs. Medicare Advantage

Both paths include access to the negotiated drugs through Part D coverage, but the structure differs. Original Medicare paired with a stand-alone Part D plan — and often a Medigap policy — generally offers broad provider access nationwide and more predictable medical cost-sharing when you add Medigap, with a separate monthly cost for that supplement. Medicare Advantage bundles hospital, medical and usually drug coverage into one plan, often with extra benefits and network rules, and medical cost-sharing works differently. Neither is universally better; the right fit depends on your doctors, your medications, your budget and how you like to receive care.

If you have Medicaid or Extra Help

Since 2025, people with Medicaid or the Part D Low-Income Subsidy (Extra Help) have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can also enroll in an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

A few 2027 numbers still to come

Some national figures for 2027 have not been announced yet, including the Part B standard premium and deductible and the IRMAA income-related surcharge brackets. CMS typically releases these in the fall. Social Security has announced a 3.6 percent cost-of-living adjustment (COLA) for benefits payable beginning January 2027. The Part D base beneficiary premium — used in calculating the late-enrollment penalty — is $41.33 for 2027; actual plan premiums are set plan by plan.

Where to get official help

For plan comparisons, formulary details and current rules, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week.