CMS to seek Medicare negotiations on Ozempic price

The Centers for Medicare and Medicaid Services (CMS) has included Ozempic among the next 15 drugs chosen for Medicare negotiation.

CMS listed Ozempic, Rybelsus and Wegovy — all forms of semaglutide — at the top of the list of drugs for which Medicare will the negotiate the price of 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.

Ozempic has become emblematic of the explosive enthusiasm for GLP-1 medications in the U.S. Danish pharmaceutical giant Novo Nordisk is the manufacturer of Ozemipc. Its diabetes medication NovoLog was among the first 10 drugs chosen for Medicare negotiation.

The company filed a lawsuit seeking to stop the Medicare negotiation process shortly after NovoLog was named, with a federal judge ruling against the company's arguments last year.

"Novo Nordisk remains opposed to government price setting through the IRA and has significant concerns about how the law is being implemented by this administration, including aggregating multiple products that individually would not meet the requirements of the statute," a Novo Nordisk spokesperson said in a statement.

"Even as our IRA lawsuit progresses, we remain committed to working with policymakers to advance solutions to ensure access and affordability for all patients," they added. "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."

Semaglutide's selection was based on a set of criteria in the Inflation Reduction Act. The drug has to be over seven years old; Ozempic just meets this requirement given its approval in December 2017.

A drug also must not have any generic or biosimilars on the market if chosen for Medicare negotiation. Though compounded versions of semaglutide have proliferated in recent years, these products are not considered generic versions of semaglutide and are not approved by the Food and Drug Administration (FDA).

The first round of Medicare negotiations yielded discounts on drugs ranging from 40 to 80 percent, including 76 percent off the list price for NovoLog.

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