Trump strikes deal with Eli Lilly and Novo Nordisk

President Donald Trump reached historic agreements Thursday with Elie Lilly And Novo Nordisk to reduce the prices of their blockbuster weight loss drugs.

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

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

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

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

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

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

Patients are eligible if they belong to these three cohorts:

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

Eli Lilly and Novo Nordisk have voluntarily agreed to reduce the prices the government pays for existing GLP-1 drugs already approved for diabetes and other uses to $245 per month, for all non-initial doses. The savings from these price reductions will allow Medicare to begin paying the same price for GLP-1 for patients with obesity and high metabolic or cardiovascular risk.

The deal will also allow patients to obtain GLP-1 on direct-to-consumer platforms at deeper discounts than they already receive through the drugmakers’ existing sites.

On TrumpRx — the government’s direct cash prescription drug purchasing platform scheduled to launch next year — the average monthly cost of Wegovy, Zepbound and other injectable GLP-1s will start at $350 and drop to $250 over the next two years, according to senior administration officials.

Initial doses of Eli Lilly and Novo Nordisk’s upcoming obesity pills, pending approval, will cost $149 a month on TrumpRx, Medicare and Medicaid. Under the deals announced Thursday, Eli Lilly will receive an expedited review of its next pill.

Eli Lilly announced Thursday that it would reduce prices by $50 on its own direct-to-consumer platform, LillyDirect, which already offers Zepbound and other drugs at a discount to patients paying cash. Zepbound’s multidose pen will be available for $299 per month at the lowest dose, with additional doses going 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 obesity medications is patchy.

But Novo Nordisk and Eli Lilly agreed to extend the lower government price for their GLP-1 drugs — $245 per month for all other non-initial doses — to all 50 Medicaid programs for all covered uses.

States will have to adhere to these prices, which means some won’t be able to. Check with your state government for coverage.