Why Ozempic Costs $685.00 Per Claim
Ozempic (Semaglutide) is used to treat diabetes. According to CMS Medicare Part D spending data, the program spent $5.0B on this drug, covering 1,180,000 beneficiaries across 7,240,000 claims.
This drug is currently protected by patents expiring Sep 20, 2031. Until patent protection ends, no generic version can enter the market, which limits price competition. Once generics become available, the price typically drops 80-95%.
Spending on Ozempic increased by +72.5% year-over-year, driven by rapidly growing utilization and potential price increases.
Price Breakdown
Drug Details
Frequently Asked Questions
Ozempic (Semaglutide) costs an average of $685.00 per claim based on Medicare Part D data. The estimated annual cost per patient is $4,200.00. Actual out-of-pocket costs depend on your insurance plan and pharmacy.
Ozempic averages $685.00 per Medicare Part D claim — roughly equivalent to a 30-day supply for most patients on standard dosing. Without insurance, expect higher cash-pay prices unless you use a discount program (GoodRx, SingleCare, manufacturer copay assistance). With Medicare or commercial insurance, your out-of-pocket cost depends on your plan's formulary tier and deductible status.
A typical 30-day supply of Ozempic reflects in our Medicare Part D average of $685.00 per claim. No generic is available yet, so cost remains at brand-name pricing. Cash-pay prices vary by pharmacy — comparison shopping (or using GoodRx coupons) often saves 20-50% off the listed price.
Most commercial insurance plans and Medicare Part D plans cover Ozempic, but coverage varies by formulary tier. Ozempic is often Tier 2 or Tier 3 on most formularies, meaning a higher copay than generic alternatives. Some plans require prior authorization or step therapy. Check your plan's formulary or call the number on your insurance card to confirm.
Several options for cash-pay patients: (1) Manufacturer patient assistance programs — the manufacturer may offer copay cards or free-drug programs for income-qualified patients; (2) Discount programs like GoodRx, SingleCare, or RxSaver typically save 20-80% off the cash price; (3) Mark Cuban's Cost Plus Drugs offers transparent generic pricing if a generic is available; (4) 340B-eligible community health centers offer drugs at federally negotiated discounts. Patient assistance programs are the primary affordability path while no generic is available.
Ozempic is still under patent protection until Sep 20, 2031, giving the manufacturer market exclusivity. Once the patent expires, generics enter the market and prices typically fall 80-95% within 1-2 years.
No, Ozempic is currently brand-only. Patent protection expires Sep 20, 2031, after which generic versions may enter the market.
Medicare Part D spent $5.0B on Ozempic, covering 1,180,000 beneficiaries across 7,240,000 claims. This makes it one of the tracked drugs in the Medicare spending dashboard.
Check manufacturer patient assistance programs for potential savings. You can also compare prices at different pharmacies, use prescription discount programs (GoodRx, SingleCare, Cost Plus Drugs), or ask your doctor about therapeutic alternatives in the same drug class.
The this entity record above pulls directly from CMS Medicare Part D Drug Spending data. What follows is the per-entity context — how this entity sits in the broader U.S. Medicare prescription-drug pricing distribution and which underlying factors drive the headline numbers.
Every number on this page links back to CMS Medicare Part D Drug Spending data; the methodology page describes the inputs, refresh cadence, and known limitations of the underlying data product.
Practical use of this page is in combination with the comparison and ranking pages elsewhere on the site, which surface the same data for this entity’s peers within U.S. prescription drugs. A single-entity reading without peer context can be misleading when an entity is an outlier on one axis but typical on another.
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Cost data reflects Medicare Part D spending and may not represent retail pharmacy prices. Average cost per claim represents the total drug cost (not patient out-of-pocket) divided by total claims.