Trump, Eli Lilly and Novo Nordisk reveal agreements to reduce prices of anti-obesity drugs

President Donald Trump announced agreements with Eli Lilly and Nordisk to reduce prices on some of its anti-obesity drugs, including upcoming pills, in a historic effort to expand access to expensive blockbuster treatments.

The deals will lower prices for drugs called GLP-1 for Medicare and Medicaid beneficiaries in 2026 and offer the treatments directly to consumers at a discount on a website the Trump administration will launch in January called TrumpRx.gov.

That means Medicare will begin covering obesity drugs for some patients for the first time starting in mid-2026, a long-awaited move that could expand the market for the drugs and prompt more private insurers to cover them. Certain Medicare patients will pay a $50 copay per month for all approved uses of injectable and oral GLP-1 medications, including the treatment of diabetes and obesity.

Starting doses of Eli Lilly and Novo Nordisk's upcoming obesity pills, pending approval, will be $149 a month. for everyone who gets them through Medicare, Medicaid or TrumpRx, a senior administration official who asked not to be identified told reporters during a briefing Thursday.

Novo Nordisk's oral version of its Wegovy obesity shot could hit the market by the end of the year, while Eli Lilly's pill Orforglipron could launch next year. The Food and Drug Administration said Thursday that it had issued priority review vouchers, which speed up review timelines for Eli Lilly's pill.

Initial doses of existing shots, such as Novo's Wegovy and Lilly's Zepbound, will be $350 a month at TrumpRX, but “will trend downward” to $245 a month over a two-year period, another senior administration official said during the briefing.

Wegovy and Zepbound have not been covered by Medicare for weight loss, “and they have rarely been covered by Medicaid,” Trump said in the Oval Office. “They have often cost consumers more than $1,000 a month, some much more than that… That ends as of today.”

The deals are among the most politically significant announcements to date in the Trump administration's attempt to rein in high drug costs in the United States by tying them to lower prices abroad. As part of the president's “most favored nation” policy, he has announced agreements with Pfizer, AstraZeneca and Merck Serono to sell certain drugs directly to patients at a discount, in exchange for waivers of planned pharmacy fees.

“This is the biggest drug in our country, and that is why it is the most important of all the [most favored nation] announcements we have made,” Health and Human Services Secretary Robert F. Kennedy Jr. said during the briefing. “This will have the greatest impact on the American people. “All Americans, even those who don't have Medicaid, Medicare, will be able to get the same price for their medications, for their GLP-1.”

Kennedy claimed the American public will lose 125 million pounds by this time next year, and said expanded access will have “dramatic effects on human health” in the US.

The event was delayed when a man standing behind Trump fainted.

The list prices of existing anti-obesity medications (approximately $1,000 to $1,350 per month before insurance) are a huge barrier for patients, many of whom could benefit from their ability to promote weight loss and alleviate other related health complications, such as cardiovascular risks and sleep apnea. Eli Lilly and Novo Nordisk already have programs to sell their discount weight-loss drugs directly to cash-paying consumers, but the new deals appear to take those efforts to boost access a step further.

Novo Nordisk and Eli Lilly agreed to reduce the price Medicare pays for the GLP-1s it already covers for diabetes and other indications, along with obesity drugs, to $245 a month. The companies agreed to extend the lower government prices for their GLP-1 drugs ($245 per month for all other non-starter doses) to all 50 Medicaid programs for all covered uses. States will have to opt into those prices, which means some may not.

But Medicare coverage could have a bigger impact on who gets drugs because the program covers about 66 million people and is the main source of insurance for people 65 and older. The new obesity drug coverage will be enabled through a pilot program designed to cover most Medicare Part D beneficiaries, which are the program's prescription drug plans.

Another senior administration official said about 10% of Medicare beneficiaries will be eligible to receive GLP-1 for obesity, cardiovascular and metabolic benefits. Eligible patients will be divided into three cohorts. The first includes those who are overweight, have a body mass index greater than 27, or have 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.

GLP-1 for weight loss is approved for a much broader population: people who are obese or overweight with a related condition. The administration official said: “We are restricting access to patients who will benefit clinically; we have worked very hard to strike a balance between broad access that simply ensures we capture patients who will benefit clinically.”

As part of the deals, Eli Lilly and Novo Nordisk also made promises similar to those other drugmakers have made as part of Trump's most favored nation deals. The companies will guarantee most-favored-nation pricing on all new drugs they bring to market, provide that pricing to all state Medicaid programs, offer at least net U.S. pricing or most-favored-nation pricing on nearly all primary care drugs in TrumpRx, and share savings from foreign drug price increases on existing products, a senior administration official said.

Also on Thursday, Eli Lilly said it would reduce prices by $50 on its own direct-to-consumer platform, LillyDirect, which already offers discounted Zepbound to cash-paying patients. Zepbound's multidose pen will be available for $299 per month for the lowest dose, with additional doses priced up to $449 per month.

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

In a statement Thursday, Eli Lilly CEO David Ricks said the deal marks “a pivotal moment in U.S. health care policy and a defining milestone for Lilly,” which is focused on “improving outcomes, strengthening the U.S. health care system, and contributing to the health of our nation for generations to come.”

In a separate statement, Novo Nordisk CEO Mike Doustdar said, “Today's announcement will bring semaglutide medicines to more U.S. patients at a lower cost.” Semaglutide is the active ingredient in Wegovy and Ozempic.

This is not the first time the government has offered Medicare coverage for anti-obesity drugs. Former President Joe Biden proposed a rule at the end of his term that would have allowed the program to cover such treatments, but in April the Trump administration refused to finalize the measure.

Biden's proposal would have expanded access to about 3.4 million Medicare beneficiaries. But it was controversial at the time, as it would cost taxpayers up to $35 billion over nine years, according to a congressional analysis.

But some health experts argue that covering medications could eliminate the costs of treating obesity-related conditions.

Semaglutide is also included in the next round of Medicare drug price negotiations under the Inflation Reduction Act, which Biden signed into law in 2022. Trump is expected to reveal new prices for the 15 drugs selected for those talks by Nov. 30.

Tirzepatide, the active ingredient in Eli Lilly's Zepbound and the Mounjaro diabetes shot, likely won't be eligible for those negotiations until the end of the decade.