Lower Medicare Drug Prices in 2027: What Fresno Seniors Should Know About the 15 Newly Negotiated Drugs
By Dr. Harman Virk, DO — Board‑Certified Internal Medicine, The Modern Medicine Group (Fresno, CA)
Medical disclaimer: This article is educational and not medical advice. If symptoms are severe, worsening, or you’re worried—seek urgent care or call 911.
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Quick Take
Starting January 1, 2027, Medicare has negotiated lower prices for 15 more drugs, including Ozempic, Wegovy, Janumet, Tradjenta, Trelegy and Breo.
Discounts are about 38% to 85% off list prices. Medicare estimates people with Medicare will save about $685 million out of pocket.
Your copay still depends on your plan. A lower Medicare price doesn't automatically mean a lower copay for you.
Also new for 2027: the drug out-of-pocket cap rises to $2,400 and the maximum deductible rises to $700.
Check every medication in Medicare Plan Finder before Open Enrollment ends December 7, 2026.
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Table of Contents
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1) The Big Picture for 2027
Since 2022, Medicare has been allowed to negotiate prices directly with drug makers for
some of the most expensive, widely used drugs.
The first 10 drugs got negotiated prices in 2026. They include Eliquis, Jardiance, Xarelto, Januvia, Farxiga and Entresto.
15 more drugs get negotiated prices on January 1, 2027.
Insulin stays capped at $35/month, and recommended vaccines stay $0.
Some 2027 changes cost more, though:
A higher drug cap
A higher deductible
Many plans adding or raising deductibles
That's why it's important to check your own drugs during Open Enrollment.
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2) The 15 Drugs With New Negotiated Prices
Starting January 1, 2027:
Diabetes / weight:
Ozempic, Rybelsus, Wegovy (71% off list price)
Janumet / Janumet XR (85%)
Tradjenta (84%)
COPD and asthma:
Breo Ellipta (83%)
Trelegy Ellipta (73%)
Digestive health:
Linzess (75%)
Xifaxan (63%)
Skin and joints:
Otezla (65%)
Lung disease:
Ofev (50%)
Cancer:
Pomalyst (60%)
Ibrance (50%)
Xtandi (48%)
Calquence (40%)
Mental health / neurology:
Vraylar (44%)
Austedo / Austedo XR (38%)
Important: These are prices Medicare pays the drug maker. What you pay depends on your plan's tier, copay or coinsurance, and whether you've met your deductible.
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3) What This Means for Fresno Patients
Several of these drugs treat conditions that are especially common in the Central Valley:
Diabetes:
Fresno County has high rates of diabetes and prediabetes.
Ozempic, Janumet and Tradjenta are on the 2027 list, and Jardiance, Januvia and Farxiga were on the 2026 list.
COPD and asthma:
Fresno's air quality is among the worst in the nation, especially during smoke and ozone season.
Trelegy and Breo inhalers are now on the list.
Heart and blood clots:
Eliquis, Xarelto and Entresto (2026 list) keep their negotiated prices.
If you take one of these drugs:
Ask whether your plan's 2027 copay went down.
If you pay coinsurance (a percentage), you're more likely to see savings than with a flat copay.
If cost has made it hard to take a medicine as prescribed, talk to your doctor. Your options may be better in 2027.
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4) 2027 Cap and Deductible: What's New
Out-of-pocket cap: $2,400 in 2027 (up from $2,100 in 2026). After you reach it, covered drugs cost $0 for the rest of the year.
Maximum deductible: $700 (up from $615).
Premium help ending: A federal program that helped hold down standalone Part D premiums ends after 2026.
Good news for Californians: standalone Part D premiums start as low as $5.30/month, and every current California standalone Part D enrollee can find a cheaper plan than the one they have.
For how the cap works, what counts toward it and what doesn't,
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5) Weight-Loss Medications: The Medicare GLP-1 Bridge
Medicare normally doesn't cover drugs used only for weight loss. A temporary program,
the Medicare GLP-1 Bridge, runs through December 31, 2027:
$50 copay per prescription, with prior authorization
Covers certain GLP-1 medications, including Wegovy and Zepbound
Eligibility depends on BMI plus certain health conditions, such as:
Heart disease
Prior stroke
Prediabetes
Kidney disease
Uncontrolled high blood pressure
If you have type 2 diabetes, your GLP-1 is covered through your regular Part D plan, not the Bridge.
Ask your doctor whether you may qualify.
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6) How to Check Your Drugs Before December 7
1. Get an accurate medication list with names and doses. Your doctor's office can help.
2. Go to Medicare Plan Finder (Medicare.gov/plan-compare) starting October 15.
3. Enter every drug and dose, plus your pharmacy.
4. For each plan, check:
Is each drug covered?
What tier?
Any prior authorization or step therapy?
5. Compare total yearly drug cost, not just the premium.
6. Spread costs if needed. The Medicare Prescription Payment Plan now renews automatically, but you must sign up again if you switch plans.
7. Check if you qualify for Extra Help, and get free help from HICAP: (559) 224-9117 or 1-800-434-0222.
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7) Frequently Asked Questions
Will my Ozempic or inhaler be cheaper in 2027?
Medicare pays a lower negotiated price starting January 1, 2027. How much you save depends on your plan's copay or coinsurance. Check it in Plan Finder.
Do I need to do anything to get the negotiated price?
No sign-up is needed. But make sure your drug is on your 2027 plan's drug list.
Is insulin still $35?
Yes. Covered insulin stays capped at $35 per month.
What's the drug out-of-pocket cap for 2027?
$2,400 for covered Part D drugs. After you reach it, covered drugs cost $0 for the rest of the year.
Does Medicare cover weight-loss drugs in 2027?
Through the temporary GLP-1 Bridge, some patients who meet specific criteria can get certain GLP-1 drugs for a $50 copay with prior authorization.
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Fresno CTA — The Modern Medicine Group
Open Enrollment is your chance to make sure your 2027 plan covers the medications you actually take, at a cost you can manage.
Before enrollment ends on December 7, get an accurate, current medication list. It's what every plan comparison depends on.
The Modern Medicine Group provides Fresno seniors with up-to-date medication lists, handles prior authorizations, finds affordable alternatives when drug coverage changes, and keeps chronic care on track through plan changes. Call us to confirm whether a specific plan and medical group are accepted by our office.
Visit: 7053 N. Cedar Ave., Fresno, CA 93720
Phone: 559-369-7787
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