Metabolic · United States · In-Market

US Type 2 Diabetes Pricing Strategy Model

Two IRA negotiation cycles have now cut across the T2D formulary: Januvia down 79% to $113, Jardiance down 66% to $197, Farxiga down 68% to $178 from January 2026, and semaglutide down 71% to $274 with Janumet and Tradjenta added for 2027.

9-sheet modelTwo-cycle IRA negotiation trackerIn-MarketUpdated Q3 2026
Market United States Stage
The Landscape

IPAY 2026 already cut three T2D agents by 66-79%. IPAY 2027 adds semaglutide, Janumet, and Tradjenta to the same table, and each cycle changes the competitive net-price map differently.

Type 2 diabetes has more IRA-negotiated agents on the books than any other therapy area, because CMS selected agents from this class in both of its first two negotiation cycles. IPAY 2026, effective January 1 2026, set Maximum Fair Prices of $113 a month for Januvia (sitagliptin) off a $527 list, a 79% cut; $197 for Jardiance (empagliflozin) off $573, a 66% cut; and $178 for Farxiga (dapagliflozin) off $556, a 68% cut. Those three cuts alone reset the DPP-4 and SGLT2 formulary tiers that most commercial plans had built around list-minus-rebate economics.

IPAY 2027 widens the negotiated set again, and does so across drug classes rather than within one. Semaglutide's franchise (Ozempic, Rybelsus, Wegovy) is cut 71% to $274 for a 30-day supply off a roughly $959 list. Janumet (sitagliptin/metformin) and Tradjenta (linagliptin) join the negotiated list for the same cycle. A pricing strategy built only on the IPAY 2026 cohort is now incomplete; the negotiated share of the T2D formulary roughly doubles in scope from 2026 to 2027, and each new agent added changes which comparator a payer will reference when negotiating the agents CMS has not yet touched.

ICER's 2019 assessment of oral semaglutide (Rybelsus) is the value-based anchor still in use for the DPP-4/SGLT2/GLP-1 comparison, and it is not a flat verdict. ICER found oral semaglutide met cost-effectiveness thresholds as an add-on to metformin, but rated it less cost-effective than empagliflozin in the same add-on-to-metformin position. That finding predates both negotiation cycles, and the two negotiated prices now sitting below ICER's threshold (Jardiance's $197 MFP, semaglutide's $274 MFP) change how that 2019 ranking should be read for a 2026-2027 formulary decision.

79%
IPAY 2026 Maximum Fair Price discount for Januvia (sitagliptin), from $527 list to $113, effective January 1 2026
66%/68%
IPAY 2026 discounts for Jardiance ($573→$197) and Farxiga ($556→$178), same effective date
71%
IPAY 2027 semaglutide franchise discount to $274 for a 30-day supply, plus Janumet and Tradjenta newly added to the same cycle
2019
year of ICER's oral semaglutide assessment, still the reference value-based comparison against empagliflozin as metformin add-on therapy
TWO-CYCLE NEGOTIATION TRACKER

US type 2 diabetes IRA negotiation — IPAY 2026 vs IPAY 2027 compared

AgentNegotiation CycleList Price (monthly)Negotiated MFPDiscount
Januvia (sitagliptin)IPAY 2026 (eff. Jan 1 2026)$527$11379%
Jardiance (empagliflozin)IPAY 2026 (eff. Jan 1 2026)$573$19766%
Farxiga (dapagliflozin)IPAY 2026 (eff. Jan 1 2026)$556$17868%
Semaglutide (Ozempic/Rybelsus/Wegovy)IPAY 2027 (eff. Jan 1 2027)~$959$27471%

Sources: CMS Medicare Drug Price Negotiation Program, IPAY 2026 and IPAY 2027 selected-drug lists and negotiated price announcements; published manufacturer WAC pricing; ICER Institute for Clinical and Economic Review, diabetes treatment assessment, 2019. Janumet and Tradjenta are confirmed IPAY 2027 additions; their negotiated MFPs are not yet published and are flagged as a methodology gap for a future update rather than estimated here.

Commercial Questions

What this model answers

Every section answers a named commercial question your team is asking, scoped to your asset.

01
How do the IPAY 2026 cuts to Januvia, Jardiance, and Farxiga change the net-price map across the DPP-4 and SGLT2 tiers?

Delivers

  • Agent-by-agent MFP vs list comparison for all three IPAY 2026 agents
  • The formulary-tier implication of a 66-79% list cut landing on a single effective date
  • Gross-to-net waterfall showing where existing commercial rebates now sit relative to the negotiated floor
02
What does IPAY 2027 adding semaglutide, Janumet, and Tradjenta do to the competitive set an un-negotiated agent has to price against?

Delivers

  • The IPAY 2027 negotiated cohort and its $274 semaglutide MFP mechanics
  • Cross-cycle comparison of IPAY 2026 vs IPAY 2027 negotiated agents
  • Analysis of which T2D agents remain un-negotiated and their pricing exposure
03
Does ICER's 2019 cost-effectiveness ranking of oral semaglutide vs empagliflozin still hold once both agents carry a negotiated MFP?

Delivers

  • ICER's 2019 add-on-to-metformin cost-effectiveness findings for both agents
  • Reassessment of that ranking against the $197 and $274 negotiated prices
  • Formulary-positioning implications for a plan rebuilding its T2D tier after two negotiation cycles

Custom model delivered in 72 hours.

Commission This Model
Contents

What's inside

Metabolic · 24–32 pp · In-Market · Analyst report + Excel model + PowerPoint readout

1 The Binding Constraint 2 pp
  • Why two overlapping IRA negotiation cycles, not a single cut, is the pricing fact a T2D formulary strategy must be built around
  • Pressure-tested against the IPAY 2026 and IPAY 2027 negotiated lists before the rest of the model is built out
2 IPAY 2026 Negotiated Prices 3 pp
  • Januvia, Jardiance, and Farxiga MFP mechanics and January 1 2026 effective date
  • The 66-79% discount range and its formulary-tier implications
3 IPAY 2027 Negotiated Prices 3 pp
  • Semaglutide franchise MFP at $274, plus Janumet and Tradjenta newly added
  • How the negotiated cohort roughly doubles in class scope from 2026 to 2027
4 Un-Negotiated Agent Exposure 2 pp
  • Which T2D agents remain outside both negotiation cycles
  • Pricing-parity gap this creates against the negotiated cohort
5 ICER Value-Based Benchmark — Oral Semaglutide vs Empagliflozin 3 pp
  • 2019 add-on-to-metformin cost-effectiveness findings
  • Reassessing the ranking against both agents' negotiated MFPs
6 GTN Waterfall Across Both Cycles 3 pp
  • Gross-to-net build from WAC to net for each negotiated agent
  • Where existing commercial rebates land relative to the negotiated floor
7 Formulary-Tier Scenarios & Sensitivity 3 pp
  • Conservative, base, and aggressive formulary-repositioning scenarios
  • Sensitivity ranking of negotiation-cycle timing and un-negotiated agent list-price movement
8 Client Alignment Questions 2 pp
  • The open pricing questions your team must close before a T2D formulary position is locked
Appendix and source ledger included · 45-minute analyst readout included with delivery
Formats

Included with every brief

PDF
PDF Brief
Pricing Strategy Brief — Complete Edition
PDF methodology brief accompanying the 9-sheet pricing model: two-cycle IRA negotiation tracker, ICER benchmark, and GTN waterfall for type 2 diabetes in the US.
XLS
Excel Model
Pricing Strategy Model — Excel
9-sheet editable model: IPAY 2026 Tracker, IPAY 2027 Tracker, Un-Negotiated Exposure, ICER Benchmark, GTN Waterfall, Formulary Scenarios, Sensitivity, QC & Sources.
Methodology

How AXLRx builds this model

Prepared by MoatRx analysts.

Every AXLRx pricing model tracks negotiated price by cycle, since IRA negotiation rolls out class by class over multiple years and a single-cycle snapshot understates how much of the formulary is negotiated by the time a plan year takes effect.

Type 2 diabetes US pricing sources: CMS Medicare Drug Price Negotiation Program IPAY 2026 and IPAY 2027 announcements, published manufacturer WAC pricing, and the ICER diabetes treatment value assessment, 2019.

  • Januvia, Jardiance, and Farxiga IPAY 2026 negotiated prices and discount percentages verified against the CMS IPAY 2026 selected-drug list and negotiated price announcement
  • Semaglutide's IPAY 2027 $274 MFP and 71% discount, plus Janumet and Tradjenta's addition to the same cycle, verified against the CMS IPAY 2027 selected-drug list
  • ICER's 2019 oral semaglutide vs empagliflozin cost-effectiveness finding verified against ICER's published 2019 diabetes treatment assessment
  • Janumet and Tradjenta's addition to the IPAY 2027 negotiated list is confirmed; their negotiated MFP figures are not yet published and are flagged as a known gap rather than estimated
FAQ

Frequently asked questions

Deliverables
What formats are included with every model?
Every commissioned Pricing Strategy Model includes an editable 9-sheet Excel model (IPAY 2026 Tracker, IPAY 2027 Tracker, Un-Negotiated Exposure, ICER Benchmark, GTN Waterfall, Formulary Scenarios, Sensitivity, QC & Sources) and a PDF methodology brief, no PowerPoint deck, since a pricing model is built to be worked in directly rather than presented from. An optional 45-minute analyst readout call is included.
Sources
How is the pricing evidence verified?
AXLRx builds from primary sources: CMS's own Medicare Drug Price Negotiation Program publications for both IPAY cycles, manufacturer-published WAC pricing, and ICER's formal value assessments. Every negotiated price, discount percentage, and cycle date is independently verified before inclusion.
Customisation
Can I model a specific payer channel, plan type, or un-negotiated comparator?
Yes. The intake form captures your target payer channel, plan mix, and comparator agents, including un-negotiated agents outside both IPAY cycles. A scoping call confirms scope before research starts. Commission via the intake form to start.
Get Started

Commission this model

AXLRx delivers type 2 diabetes pricing strategy models built for market access and pricing teams navigating two overlapping IRA negotiation cycles. Custom model in 72 hours.

1
Submit your request

Specify your target payer channel, plan mix, and comparator agents.

2
Scoping call

AXLRx analyst confirms negotiation-cycle scope and formulary comparator set before building.

3
Delivery

Research-verified pricing model in 72 hours with optional analyst readout.