Maryland’s Prescription Drug Affordability Board has voted to place an upper payment limit on Ozempic for state and local government health plans, a first for the nation, and a move supporters said could save about $5.8 million annually.
The board determined Ozempic, the brand name for semaglutide, is unaffordable for Marylanders and approved a proposal to cap how much state and municipal government health plans pay for the drug, according to a May 19 Maryland Matters report.
The proposal is subject to a 30-day public comment period and would not take effect before Jan. 1, 2027, if finalized. The board also voted to explore additional cost-reduction strategies for GLP-1 drugs, including a subscription payment model in which the state would pay an annual fee for expanded access to semaglutide.
The Ozempic decision follows an April vote to establish an upper payment limit for Jardiance, another Type 2 diabetes drug. A Maryland law passed in 2025 allows the board to potentially expand payment limits beyond state health plans after two drugs have been subject to upper payment limits for at least one year.
However, patient advocacy groups and pharmaceutical industry representatives argued the policy could create barriers to access through formulary changes and utilization management requirements, according to the report. During the board’s comment period, Novo Nordisk pointed to its White House agreement to offer Ozempic for as low as $199 per month through NovoCare Pharmacy for Medicaid and uninsured patients as evidence that the affordability landscape had shifted since the board’s August 2024 data cutoff.
The board maintained that its determination stood on the data available at the time. Whether the cap ultimately delivers savings to patients — or creates new hurdles to access — is a question that will play out during the upcoming comment period and, if finalized, in the first year of implementation.
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