Prescription drug costs shouldn’t stand between people and the care they need.

For many older adults living with diabetes, medication costs can be one of the biggest barriers to staying healthy. That’s why recent changes allowing Medicare to negotiate drug prices are such an important step forward, especially for people who rely on newer high-cost diabetes medications.

💊 What Changed: Medicare Can Now Negotiate Drug Prices

The Inflation Reduction Act gave Medicare the ability to negotiate prices for some of the most expensive brand-name medications covered under Medicare Part D. These negotiated prices are designed to reduce out-of-pocket costs for beneficiaries while also lowering overall Medicare spending.

The first round of negotiated prices took effect in 2026, with additional drugs continuing to be added each year afterwards.

💊 Diabetes Medications Included in the First Negotiations

Among the first group of drugs selected are several medications commonly used by people with diabetes, including:

  • Farxiga (SGLT2)
  • Fiasp (fast-acting insulin)
  • Januvia (DPP-IV)
  • Novolog (fast-acting insulin)

These medications were chosen because they are widely used, costly, and most lack generic or biosimilar competition. In 2022 alone, Medicare spent tens of billions of dollars on just these drugs. Find more information on the CMS website here.

 💊 Why GLP-1 Medications Are a Big Part of This Conversation

GLP-1 medications have changed the way many people manage type 2 diabetes. These medications help:

  • Lower blood sugar
  • Reduce appetite
  • Support weight loss
  • Improve heart and kidney health

Common GLP-1 Medications include:

  • Mounjaro
  • Ozempic
  • Rybelsus
  • Trulicity
  • Wegovy

However, GLP-1 medications have also come with very high price tags, often nearing $1,000 per month, making access difficult for many Medicare beneficiaries.

 💊 GLP-1 Medications and Upcoming Medicare Savings

The good news: GLP-1 medications are now part of the future Medicare price negotiations.

Beginning in 2027, negotiated prices for Ozempic, Wegovy, and Rybelsus are expected to reduce costs by as much as 71% off current list prices. This could bring monthly costs down to roughly $274 per month, depending on the medication and plan coverage. Find out more from CMS here.

These reductions could make GLP-1 therapy more accessible for people who previously had to stop, or never start these medications due to cost.

 💊 Current Access Option: Lilly’s Agreement with the US Government

In November 2025, Eli Lilly announced an agreement with the US government to expand access to obesity medications for people covered by Medicare and Medicaid. Under this agreement, Medicare beneficiaries with obesity or overweight may be able to access Zepbound (tirzepatide) for no more than $50 per month, beginning as early as April 2026. States may also choose to expand access to these medications through their Medicaid programs. Additional options for people paying out of pocket may be available through LillyDirect, depending on medication approval and eligibility. Full details are available on Lilly’s website.

 💊 What’s Coming Next

Beyond Lilly’s program, broader changes are expected in 2027 with the launch of the CMS BALANCE Model, a new Medicare and Medicaid program designed to expand access to GLP-1 medications while pairing them with lifestyle and nutrition support. You can learn more about the upcoming BALANCE program on the CMS website.

💊 Why Lower Drug Prices Matter for Diabetes Care

More affordable medications can lead to:

  • Better blood sugar control
  • Improved medication adherence
  • Reduced risk of diabetes complications
  • Greater flexibility in choosing treatment options

For many people with diabetes, affordability directly impacts long-term health outcomes, not just finances.

📌 What to Know Going Forward

  • Negotiated prices will roll out gradually
  • Savings apply to Medicare Part D
  • Coverage details may vary by plan
  • Reviewing your Medicare plan each year is important

If you take diabetes medications or are considering newer options such as GLP-1s, now is a great time to talk with your healthcare provider on how upcoming changes may affect you.

 

Summary

Lower Medicare drug prices mark a major shift in diabetes care affordability. With insulin, oral diabetes medications, and GLP-1 therapies included in upcoming negotiations, millions of Medicare beneficiaries may soon see meaningful relief at the pharmacy counter. These changes aim to support better access, better adherence, and better health outcomes for people living with diabetes.