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A January 2025 report said Eli Lilly and other drugmakers planned to urge the incoming Trump administration to pause Medicare drug-price negotiations. It did not establish that a formal request was made or that negotiations were paused. In the end, CMS selected Novo Nordisk’s Ozempic, Rybelsus and Wegovy for the program’s second cycle; their Medicare negotiated prices are scheduled to take effect January 1, 2027.
What the January 2025 report said—and what it did not establish
On January 14, 2025, Ars Technica reported that Eli Lilly and other drugmakers were expected to ask the incoming Trump administration to pause negotiations created by the Inflation Reduction Act (IRA). At the JPMorgan Healthcare Conference, Lilly CEO Dave Ricks said, “They need to fix [the IRA].” The report described an anticipated request, not confirmation that a formal request had been filed or granted.
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Ricks also argued to CMS nominee Mehmet Oz that Medicare plans should list the drugs, saying: “My argument to Mehmet Oz is that if you want to protect Medicare costs in 10 years, have [the Affordable Care Act] and Medicare plans list these drugs now,” and, “We know so much about how much cost savings there will be downstream in heart disease and other conditions.” Those are Ricks’s claims about potential downstream savings, not an estimate of the second-cycle negotiation’s savings.
CMS selected the three semaglutide products
CMS announced the second-cycle selection on January 17, 2025, naming 15 Part D drugs, including Ozempic, Rybelsus and Wegovy, all Novo Nordisk semaglutide products. The selection resolved whether those medicines would be included in that cycle: they were. Selection, however, was only one step in the process.
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On March 14, 2025, CMS said manufacturers of all 15 selected drugs had signed participation agreements; Novo Nordisk was listed for the three semaglutide products. CMS later reported that agreements had been reached for all 15 drugs. The resulting prices are scheduled to apply beginning January 1, 2027. See CMS’s selection announcement, its participation announcement, and its January 2026 update on the completed second cycle.
What the $274 Medicare price means
CMS lists a negotiated price of $274 for a 30-day supply of Ozempic, Rybelsus and Wegovy, compared with a 2024 list price of $959. The $274 is the Medicare negotiated maximum fair price scheduled to apply in 2027, not a general retail or cash price. It does not mean every Medicare beneficiary will be eligible for coverage, nor does it determine what a particular person will pay out of pocket. The figures and their program context are in CMS’s 2027 price fact sheet and its current selected-drugs and negotiated-prices page.
CMS also estimated that if the second-cycle prices had been in effect in 2024, aggregate net covered Part D spending across all 15 selected drugs would have been about $8.5 billion, or 36 percent, lower. That is a CMS counterfactual for the full selection, not savings attributed to semaglutide alone.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Negotiated prices do not settle Medicare coverage
A negotiated price and a coverage decision answer different questions. Negotiation sets a price under the Medicare program; coverage depends on the applicable Medicare rules, the drug’s medically accepted indication and the beneficiary’s plan. The 2025 report described the general rule at that time as excluding drugs prescribed specifically for weight loss from Medicare’s standard prescription benefit while allowing coverage for GLP-1 medicines used for other medically accepted indications. It noted that Wegovy could be covered for a qualifying cardiovascular risk-reduction use.
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One free scan finds every outdated or missing driver and matches the right update for your exact hardware.Free scan · exact hardware matchThat historical description is not a beneficiary-specific coverage determination for every indication or plan as of October 8, 2026. Anyone checking eligibility should consult current CMS guidance and the relevant plan’s coverage materials; the negotiated price alone cannot confirm that a prescription is covered.
Why CBO’s $35.5 billion estimate is a different figure
The Congressional Budget Office’s October 2024 analysis modeled a hypothetical policy allowing Medicare to cover anti-obesity medications beginning in 2026. For 2026–2034, CBO estimated $38.8 billion in direct federal costs and $3.4 billion in offsetting savings from improved health, for a net increase of $35.5 billion in federal spending. CBO described the estimates as highly uncertain and sensitive to uptake, prices, clinical effects, eligibility and policy scope. This was a modeled estimate of broader coverage, not the cost or savings of the semaglutide negotiation deal. The analysis is available from the Congressional Budget Office.
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