The Centers for Medicare and Medicaid Services (CMS) listed Ozempic, Rybelsus and Wegovy — all forms of semaglutide — at the top of its list of drugs selected for Medicare negotiation in 2025.
The list price for a one-month supply of Ozempic costs close to $1,000 without insurance or manufacturer coupons. According to CMS data, Medicare Part D spending on Ozempic was more than $4.6 billion in 2022.
Semaglutide's selection was based on a set of criteria in the Inflation Reduction Act (IRA). The drug has to be more than seven years old, a requirement Ozempic just met given its December 2017 approval.
Drugs with generics or biosimilars on the market are ineligible for Medicare negotiation, and though compounded versions of semaglutide have proliferated in recent years, these products are not considered generic versions and are not approved by the Food and Drug Administration.
CMS had until Feb. 1 to publish the next round of drugs chosen for Medicare negotiation.
When asked if President-elect Trump's imminent inauguration had anything to do with the early release, administration staffers said CMS had routinely been ahead of schedule during the Medicare negotiation process.
Novo Nordisk, the manufacturer of semaglutide, engaged in Medicare negotiations last year after its diabetes medication NovoLog was selected. The company said it "remains opposed to government price setting."
"Even as our IRA lawsuit progresses, we remain committed to working with policymakers to advance solutions to ensure access and affordability for all patients," a Novo Nordisk spokesperson said in a statement to The Hill.
"That is why we are deeply concerned about the price-setting process, which could negatively impact patients' ability to access their medicines and threatens to stifle future scientific development of life-changing medicines for chronic diseases in which there is a real unmet need."
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