Trump strikes deal with Eli Lilly, Novo Nordisk

Under the agreements, the monthly out-of-pocket cost of popular injections and upcoming pills could range from $50 to $350 starting next year, depending on the dosage and insurance coverage a patient has, Trump administration officials said.

Existing GLP-1s, including Eli Lilly’s obesity injection Zepbound and Novo Nordisk’s competitor Wegovy, carry list prices above $1,000 a month, which has prevented many patients from taking them. Both companies have introduced lower cost options for people paying in cash and purchasing the drugs directly through their websites.

But the deals with Trump, as part of his “most favored nation” policy, take those efforts to expand access even further. Here’s how much weight loss drugs could cost for patients under the new agreements, based on the details shared so far.

Medicare has covered GLP-1 drugs for diabetes and some other medical conditions: for example, Wegovy for slashing cardiovascular risks. But under the new deals, Medicare will start covering the drugs for obesity for the first time starting in mid-2026, which could allow more seniors to qualify for them and spur more private insurers to cover them.

Certain Medicare patients will pay a copay of $50 per month for all approved uses of GLP-1 drugs, including diabetes and obesity treatment.

But the Trump administration is putting some constraints on which Medicare beneficiaries will be eligible to receive GLP-1s for obesity and cardiovascular and metabolic benefits.

Patients are eligible if they fall into these three cohorts:

• The first includes those who are overweight — with a body mass index greater than 27 — or with prediabetes or established cardiovascular disease.
• The second group is people with obesity – with a BMI greater than 30 – and uncontrolled hypertension, kidney disease or heart failure.
• The third group is patients with severe obesity, or anyone with a BMI greater than 35.

Eli Lilly and Novo Nordisk voluntarily agreed to reduce the prices the government pays for existing GLP-1 drugs already approved for diabetes and other uses to $245 a month, across all non-starting doses. Savings generated by those price reductions will allow Medicare to start paying that same price point for GLP-1s for patients with obesity and a high metabolic or cardiovascular risk.

The agreement will also allow patients to get GLP-1s on direct-to-consumer platforms at steeper discounts than they already receive through drugmakers’ existing sites.

On TrumpRx – the government’s direct-to-consumer platform for buying prescription drugs with cash expected to launch next year – the average monthly cost for Wegovy, Zepbound and other injectable GLP-1s will start at $350 and drop to $250 within the next two years, according to senior administration officials.

Starting doses of upcoming obesity pills from Eli Lilly and Novo Nordisk, pending approvals, will be $145 per month on TrumpRx, Medicare and Medicaid. Under the deals announced Thursday, the drugmakers will get fast-track reviews of their forthcoming pills.

Eli Lilly on Thursday said it would lower prices by $50 on its own direct-to-consumer platform, LillyDirect, which already offers Zepbound and other drugs at a discount to cash-paying patients. The multidose pen of Zepbound will be available for $299 per month at the lowest dose, with additional doses being priced up to $449 per month.

Eli Lilly’s pill, once approved, will be available at the lowest dose starting at $149 per month

State Medicaid coverage of GLP-1 drugs for obesity is spotty.

But Novo Nordisk and Eli Lilly agreed to extend lower government pricing for their GLP-1 drugs – $245 per month across all other non-starting doses – to all 50 Medicaid programs for all covered uses.

States will have to opt into those prices, meaning some may not. Check with your state government about coverage.