Administration Anounces Landmark GLP-1 Pricing Agreement with Eli Lilly and Novo Nordisk

President Donald Trump announced a comprehensive agreement Thursday with pharmaceutical manufacturers Eli Lilly and Novo Nordisk that will signficantly reduce prices for GLP-1 receptor agonist antiobesity medications and expand coverage through Medicare and Medicaid. The deals are the most politically significant drug pricing announcement to date from the administration's efforts to tie US pharmaceutical costs to the lowest international prices.

How the Agreements Work

Under the agreements, Medicare will cover obesity drugs for the first time starting mid-2026 through a pilot program designed to reach a majority of Part D prescription drug plan beneficiaries, according to CNBC.1 Copays for eligible Medicare patients will run $50 per month for all approved uses of injectable and future oral GLP-1 drugs, including for diabetes and obesity treatment. The New York Times reports that approximately 10% of Medicare beneficiaries will qualify for coverage, based on criteria that include overweight with a body mass index greater than 27 and a diagnosis of prediabetes or established cardiovascular disease.2

Pricing is Variable

The pricing structure varies significantly by formulation and distribution channel. Starting doses of yet-to-be approved oral versions of these medications will cost $145-$150 per month across Medicare, Medicaid, and the administration's new TrumpRx.gov website launching in January 2026, according to CNBC.3 Novo Nordisk's oral version of semglutide (Wegovy) could enter the market by year-end,4 while Eli Lilly's orforglipron pill may launch next year.5

For existing injectable formulations like semaglutide and tirzepatide (Zepbound), Americans purchasing directly from manufacturers will initially pay approximately $350 per month, with prices expected to decline to $245 over a 2-year period, the Times reported.2 This represents a substantial reduction from current list prices of $1,000 to $1,350 per month before insurance. Medicare and Medicaid will pay $245 per month for non-starting doses across all covered uses.2,3

"This is the biggest drug in our country, and that's why this is the most important of all the [most favored nation] announcements we've made," Health and Human Services Secretary Robert F. Kennedy Jr. stated during the briefing, according to CNBC. "All Americans, even those who are not on Medicaid, Medicare, are going to be able to get the same price for their drugs, for their GLP-1s."1

Clinicians are Cautiously Optimistic

Physicians treating obesity have welcomed the announcement with measured optimism. Angela Fitch, MD, founder and chief medical officer of knownwell, a weight-loss and medical care company, and past president of the Obesity Medicine Association told the AP: "We need a hero in obesity care today. The community has faced relentless barriers to accessing GLP-1 medications, which has ultimately come down to the price, despite the data we have supporting their effectiveness."7

Leslie Golden, MD, a dual board-certified physician in obesity and family medicine, and the founder of Weight In Gold Wellness, in Watertown, Wisconsin, described the financial burden her patients using the drugs face on a regular basis: "Every visit it's, 'How long can we continue to do this? What's the plan if I can't continue?'" Golden told the AP.7 She noted that roughly 75% of her approximately 600 patients taking these treatments struggle to afford them, with some working additional jobs or delaying retirement to maintain access.7

The agreements include commitments from both manufacturers to expand US production capacity. This addresses ongoing supply constraints that have limited access and fueled a robust market for compounded versions of these medications. The FDA ordered sales of compounded GLP-1s to stop last spring when brand-name drugs were no longer in shortage, though some compounding pharmacies have continued operations using formulations that may fall into regulatory gray areas, according to the Times.1

For Medicaid programs, the pricing structure presents both opportunities and challenges. While federal law generally requires Medicaid to cover FDA-approved drugs, a specific carve-out allows states to decide whether to cover weight-loss medications.1 The new $245 monthly pricing for all covered uses may incentivize additional states to add coverage, though states must opt into these negotiated prices. Currently, only a handful of state Medicaid programs cover these medications, with several withdrawing coverage this year citing budgetary pressures, the Times reported.1

The Broader View

The announcement arrives amid broader political tensions over health care costs. A record-long government shutdown continues over congressional disagreements regarding health expenditure, with Democrats withholding votes on spending bills pending agreement to extend Affordable Care Act subsidies.

This deal follows a pattern established by similar agreements the Trump administration has negotiated with Pfizer, AstraZeneca, and EMD Serono, offering drugmakers exemptions from planned pharmaceutical tariffs in exchange for direct-to-consumer sales at reduced prices. However, as Kennedy emphasized, the GLP-1 agreement will likely have the largest consumer impact given the medications' popularity and the substantial number of Americans currently paying for them out-of-pocket.

The clinical reality remains that obesity is a chronic disease requiring indefinite treatment. Patients who discontinue these medications typically regain lost weight, making long-term affordability critical for sustained therapeutic benefit. The new pricing structure, while substantially lower than current costs, still represents a significant ongoing expense for patients and healthcare systems.

As these agreements take effect over the coming year, clinicians will need to navigate new coverage criteria, monitor the rollout of oral formulations, and counsel patients on the expanding but still selective access through Medicare and state Medicaid programs.

References

1. Murphy T, Madhani A, Aleccia J. Trump unveils deal to expand coverage and lower costs on obesity drugs. AP. November 6, 2025. Accessed November 6, 2025. https://apnews.com/article/trump-wegovy-zepbound-drug-prices-15b24e03d558aa6bbcf37e52ba2d354e
2. Robbins R, Sanger-Katz M, Blum D. Obesity drugs may drop to as little as $150 a month. New York Times. November 6, 2025. Accessed November 6, 2025. https://www.nytimes.com/2025/11/06/health/obesity-drug-prices-trump.html
3. Constantino AK. Trump announces deals with Eli Lilly, Novo Nordisk to slash weight loss drug prices, offer some Medicare coverage. [Health and Science]. CNBC. November 6, 2025. Accessed November 6, 2025. https://www.cnbc.com/2025/11/06/trump-eli-lilly-novo-nordisk-deal-obesity-drug-prices.html
4. Halsey G. Oral semaglutide 25 mg shows cardiometabolic benefits beyond weight loss in OASIS 4 analysis. Patient Care.
5. Jennings S. Investigational oral GLP-1 RA, orforglipron, yields dose-dependent weight loss in phase 3 tirals. Patient Care. September 17, 2025. Accessed November 6, 2025.