As the federal government prepares to release newly negotiated Medicare drug prices, weight-loss blockbusters Ozempic and Wegovy remain in the spotlight, while CMS advances a model to cut Medicaid spending and broaden access to affordable treatments.
Later this week, the US federal government is anticipated to reveal the negotiated prices for 15 of the most expensive prescription meds under Medicare—a program that covers more than 67 million people age 65 and over, along with those with disabilities—Reuters reports.1
Although further price decreases are not expected for Novo Nordisk’s Wegovy and Ozempic—both drugs are included on the list—the Trump administration did decide to lower these drugs’ Medicare price to $245 a month through TrumpRx for patients with Medicaid or Medicareseveral weeks ago.2
Meanwhile, Novo Nordisk and Eli Lilly are also working on oral GLP-1 medications, which will reportedly be available on the government-run DTC platform, $145-a-month. These medications will also be available for the same price through Medicare and Medicaid.3
As stated in the Inflation Reduction Act (IRA)—which provides Medicare with the right to directly negotiate with drug companies as a way to improve access to various brand name Part B and D drugs—the first round of 10 negotiated prices (announced back in August 2024) will go into effect Jan. 1, 2026, while the second round’s negotiated prices (announced this past January) will become effective in 2027.4
The latest drugs on the list, along with their approved indications, include:
Medicare must weigh multiple factors when setting prices under the IRA, including manufacturer-provided data and the availability of alternative therapies. However, it’s important to note the law does not require Medicare to evaluate international drug prices as part of this process.
Analysts noted that they will be comparing the prices against two key benchmarks: Medicare's recent net prices (after factoring in confidential rebates and discounts) and the prices negotiated by other high-income countries, a policy also known as most-favored nation (MFN) pricing.
"These prices are going to come down below the existing net prices. There will be some real savings," Sean Sullivan, professor of pharmacy at the University of Washington told Reuters.1 "All of the other payers can see them. What is going to stop them from asking manufacturers for that same price?"
Next February, Medicare will undergo the third round of drug price negotiations, which are anticipated to feature 15 more Rx and hospital-administered drugs.
In another effort to cut Medicaid drug costs and expand access to affordable meds, the Centers for Medicare & Medicaid Services (CMS) will be launching an Innovation Center initiative next year with three goals in mind: to decrease Medicaid Rx drug spending, boost health outcomes by opening up move avenues for medication access, and bolster the Medicaid program as a whole.5
Known as the GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) Model, the individual states whose Medicaid programs elect to join the pilot program will reportedly be able to buy meds at fairer, competitive prices that closely align to what is being paid in other nations.
“Thanks to President Trump’s leadership and Dr. Oz’s bold direction at CMS, we’re expanding access to affordable medicines for millions of Americans,” commented Health and Human Services Secretary Robert F. Kennedy, Jr. “By bringing most-favored-nation pricing to Medicaid, we’re driving down drug costs and protecting the future of care for our most vulnerable citizens.”
According to CMS data, the total gross Medicaid spending on prescription drugs was over $100 billion last year, representing a $10 billion increase over 2022 numbers.
References
1. Wingrove P, Beasley D. US Negotiated Medicare Prices for 15 More drugs to Test Cost Savings Promise. Reuters. November 25, 2025. Accessed November 25, 2025.
2. Hollan M. Eli Lilly and Novo Nordisk Bring Weight-Loss Medications to TrumpRx. Pharmaceutical Executive. November 6, 2025. Accessed November 25, 2025.
3. Saraceno N. WeightWatchers to Offer Novo Nordisk’s Oral Wegovy, if Approved Next Year. Pharmaceutical Commerce. November 13, 2025. Accessed November 25, 2025.
4. Saraceno N. Headlined by Ozempic, Medicare Reveals Second Round of Drugs Selected for Price Negotiations. Pharmaceutical Commerce. January 17, 2025. Accessed November 25, 2025.
5. Saraceno N. CMS Unveils Initiative to Cut Medicaid Drug Costs and Expand Access to Affordable Medications. Pharmaceutical Commerce. November 10, 2025. Accessed November 25, 2025.
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