CMS Sets 2027 Medicare Prices for Wegovy, Trelegy and Other High-Spend Drugs

The Centers for Medicare and Medicaid Services has issued the final negotiated prices for 15 drugs that will take effect in 2027, completing the second annual cycle of Medicare price negotiations mandated by the Inflation Reduction Act. CMS reported that, had these prices been in place in 2024, Medicare’s aggregate spending on the selected drugs would have been reduced by 44%, equating to $12 billion, while beneficiaries’ out-of-pocket costs would have fallen by $685 million.

The negotiation process involved three rounds of offers and counteroffers, incorporating evidence from manufacturers and CMS. According to the agency, seven drugmakers accepted a written final offer from CMS, while seven others reached agreement based on revised counteroffers. The negotiated price for semaglutide, the active ingredient in Novo Nordisk’s Wegovy and Ozempic, was previewed during an Oval Office press conference as part of an effort to align U.S. drug prices with those in other industrialized nations.

Several high-spend therapies saw notable reductions. Semaglutide, with 2.3 million Medicare users in 2024 and $15.2 billion in gross covered costs, received a negotiated monthly price of $274 compared to its 2024 list price of $959. GSK’s respiratory therapy Trelegy Ellipta, used by 1.3 million beneficiaries, was set at $175 versus a list price of $654. Among cancer therapies, the negotiated price for Astellas and Pfizer’s Xtandi was set at $7,004, compared with its prior list price of $13,480. Bristol Myers Squibb’s Pomalyst and Pfizer’s Ibrance also saw large reductions relative to their 2024 list prices of $21,744 and $15,741, respectively. AstraZeneca’s Calquence and Boehringer Ingelheim’s Ofev likewise represent substantial spending categories and were included in the negotiated set.

Other therapies selected for this round include gastrointestinal treatments such as AbbVie’s Linzess and Salix’s Xifaxan; diabetes drugs Tradjenta from Boehringer Ingelheim and Janumet from Merck; respiratory therapy Breo Ellipta from GSK; Teva’s Austedo for movement disorders; AbbVie’s Vraylar for depression; and Amgen’s Otezla for psoriasis.

These 15 medicines will follow the initial group of 10 drugs whose negotiated prices take effect in 2026. Under the IRA, only “single-source” products — generally branded drugs without generic or biosimilar competition — qualify for negotiation, extending federal oversight to some of Medicare’s highest-spend treatments.

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