Trump reaches agreement with Eli Lilly and Novo Nordisk: GLP-1 weight loss drug sees largest price drop in history, now $245 per month

U.S. President Donald Trump announced on Thursday that agreements have been reached with Eli Lilly and Novo Nordisk to significantly reduce the prices of certain weight loss drugs (including upcoming oral medications).

According to the agreement, starting in 2026, Medicare and Medicaid patients suffering from obesity along with other conditions (such as prediabetes or heart failure) will be able to obtain so-called GLP-1 drugs like Eli Lilly's Zepbound and Novo Nordisk's Wegovy at greatly reduced prices, priced at approximately $245 per month, with a $50 copayment for Medicare patients. At the same time, these drugs will also be sold directly to consumers at discounted prices through the website TrumpRx.gov, which the Trump administration plans to launch next January.

This means that starting in mid-2026, Medicare will reimburse weight loss drugs for certain patients for the first time. Analysts believe this move could expand the market for such drugs and encourage more private insurance to provide coverage. Certain Medicare patients will only need to pay a $50 copayment per month when using GLP-1 injectables and oral medications (including diabetes and weight loss treatments) under approved indications.

A senior government official, who wished to remain anonymous, told the media at a briefing on Thursday that the starting dose of the upcoming oral weight loss drugs from Eli Lilly and Novo Nordisk (after approval) will be uniformly priced at $145 per month through Medicare, Medicaid, or TrumpRx channels. Novo Nordisk's oral version of Wegovy may hit the market by the end of this year, while Eli Lilly's oral drug orforglipron may be launched next year.

Another senior government official stated to the media that existing injectable products, such as Novo Nordisk's Wegovy and Eli Lilly's Zepbound, will have a starting dose price of $350 per month on TrumpRx, but will "gradually decrease" to $245 per month over two years.

Trump stated that Wegovy and Zepbound were previously not covered by Medicare for weight loss purposes,

"Medicaid also rarely covers."

"Consumers typically had to pay over $1,000 per month, with some far exceeding that... This situation ends today."

The media reported that these agreements are among the most politically significant announcements to date in the Trump administration's efforts to curb high drug prices in the U.S. and link drug prices to the lowest prices overseas. As part of Trump's "most favored nation" policy, he has announced agreements with Pfizer, AstraZeneca, and EMD Serono to sell certain drugs directly to patients at discounted prices in exchange for waiving planned pharmaceutical tariffs.

U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. stated at the briefing,

"This is the most important class of drugs in our country, and therefore it is the most significant of all the 'most favored nation' policies we have announced."

"This will have the greatest impact on the American public. All Americans, even those not in the Medicaid and Medicare populations, will be able to access GLP-1 drugs at the same price."

Kennedy claimed that by this time next year, the American public will lose 125 million pounds (approximately 56.7 million kg) as a result, and stated that expanding access to medication will have a "significant impact" on the health of Americans.

After the announcement, the American Depositary Receipts (ADR) of Novo Nordisk initially rose but then fell by about 3%; Eli Lilly's stock fluctuated before a slight increase.

Increasing Accessibility of Weight Loss Drugs

The media reported that the current price of weight loss drugs is approximately $1,000 to $1,350 per month (before insurance reimbursement), which is a significant barrier for patients. Many patients could benefit from the weight loss effects of these drugs, as well as from alleviating cardiovascular risks, sleep apnea, and other related health issues. Eli Lilly and Novo Nordisk already have direct discount programs for self-paying patients, but the new agreement seems to further enhance accessibility.

According to the agreement, Novo Nordisk and Eli Lilly have agreed to reduce the price of GLP-1 drugs covered by Medicare for approved indications such as diabetes, as well as GLP-1 drugs for weight loss purposes, to $245 per month. The two companies agreed to extend the government's low price ($245 per month, applicable to all non-starting doses) to Medicaid programs in all 50 states for all covered indications. However, each state needs to choose to participate in this pricing, so some states may not join.

But the impact of Medicare coverage may be greater, as the program covers about 66 million people and is the primary insurance source for those aged 65 and older. The new coverage for weight loss drugs will be implemented through a pilot program aimed at covering most beneficiaries under Medicare Part D (its prescription drug plan).

Another senior government official told the media that about 10% of Medicare beneficiaries will be eligible for GLP-1 drugs for weight loss and cardiovascular and metabolic benefits. Eligible patients will be divided into three categories: the first category includes overweight individuals with a Body Mass Index (BMI) over 27, or those with prediabetes, or existing cardiovascular disease; the second category includes obese individuals with a BMI over 30 who have uncontrolled hypertension, kidney disease, or heart failure; the third category includes individuals with severe obesity, defined as anyone with a BMI over 35.

Currently, the approved coverage for GLP-1 weight loss drugs is broader: it applies to obese individuals or those who are overweight with one related disease. The official stated to the media:

"We have imposed access restrictions on patients who benefit significantly, and we are working very hard to strike a balance between expanding coverage and ensuring the clinical beneficiary population."

According to the agreement, Eli Lilly and Novo Nordisk have also made commitments similar to those of other pharmaceutical companies in participating in Trump's "Most Favored Nation" agreement. The two companies will guarantee the Most Favored Nation pricing for all newly launched drugs in the future, provide this pricing for all state Medicaid programs, offer at least the U.S. net price or Most Favored Nation price for nearly all essential medical drugs on TrumpRx, and share savings from existing products due to rising overseas drug prices with the government, a senior official told the media.

Also on Thursday, Eli Lilly announced it would reduce prices by an additional $50 on its direct sales platform LillyDirect. The platform has already been selling Zepbound to self-paying patients at a discounted price. The price for the lowest dose of Zepbound's multi-dose pen injector will drop to $299 per month, with higher doses priced up to $449 per month.

After approval, the price for Eli Lilly's oral medication will start at $149 per month for the lowest dose.

Significant Price Changes

Eli Lilly CEO David Ricks stated in a statement on Thursday that this agreement marks "a pivotal moment in U.S. healthcare policy and a milestone for Eli Lilly," and the company will continue to be committed to "improving treatment outcomes, strengthening the U.S. healthcare system, and making a long-term contribution to national health."

Novo Nordisk CEO Mike Doustdar stated in another statement, "Today's announcement will allow more American patients to access semaglutide medications at a lower cost." Semaglutide is the active ingredient in Wegovy and Ozempic.

This is not the first time the U.S. government has attempted to push Medicare coverage for weight loss drugs. Former President Biden proposed a rule before the end of his term that would allow Medicare to cover such drugs, but the Trump administration rejected finalizing the proposal in April of this year.

Biden's proposal would have allowed about 3.4 million Medicare beneficiaries to access the medication, but it was controversial at the time, as the Congressional Budget Office estimated that this policy would cost taxpayers up to $35 billion over nine years.

However, some healthcare experts believe that covering these medications could reduce future medical expenses related to treating obesity-related diseases.

Semaglutide is also included in the next round of Medicare drug price negotiations under the Inflation Reduction Act, which was signed into law by Biden in 2022. Trump is expected to announce new prices for 15 drugs participating in these negotiations by November 30.

Tirzepatide, the active ingredient in Eli Lilly's Zepbound and diabetes injection Mounjaro, may not qualify for drug price negotiations until the end of this decade