The deal could expand coverage and lower the price of GLP-1 medications for millions of Americans.
The Trump administration has struck a deal with drugmakers Eli Lilly and Novo Nordisk to offer their breakthrough weight-loss medications at steep discounts for certain Medicare and Medicaid patients, President Donald Trump announced at the White House on Thursday.
The deal also includes lower prices for GLP-1 drugs for Americans who use cash to buy them through a new government website, expected to debut next year, that will allow people to buy drugs directly from companies.
All told, the latest drug pricing deal between the Trump administration and drugmakers is poised to expand coverage and lower the price of the medications for millions of Americans. A senior administration official granted anonymity to discuss the deal said about 10 percent of the Medicare population will be eligible for expanded access.
Medicare, the government-run health care program that serves around 70 million older Americans, doesn’t cover use of the drugs solely for fighting obesity, instead only allowing coverage for people when obesity is paired with other health issues, like diabetes or sleep apnea. Thursday’s announcement expands that eligibility to more Americans, adding coverage for people with other conditions.
The specific prices Americans will pay, and when those price changes will kick in, will vary based on where people get their prescriptions — Medicare, Medicaid, or through a direct-to-consumer program.
For Medicare and Medicaid, drugs like Ozempic, Wegovy, Mounjaro and Zepbound will cost the insurance programs $245 a month. Americans on Medicare will only be responsible for a $50 copay, the White House said, and Americans on Medicaid generally pay little to no cost for prescription drugs.
For pill versions of the drugs, which are new versions of the medication that first need to face FDA approval, the price could be as low as $149 to Medicare and Medicaid. Novo Nordisk asked the FDA to approve an oral version of Wegovy in May, and Eli Lilly plans to submit an application for its weight-loss pill candidate to the agency by the end of the year.
TrumpRx.gov, the direct-to-consumer site where patients will pay directly for medications, will offer an initial dose for new patients at $149, but cost an average of $350 a month with the goal of reaching $245 in two years.
There are open questions, however, about how many people the price drops will reach. For Medicare, it will depend on how many plans choose to participate in the government’s program, which will be voluntary at first. For Medicaid, states will weigh the budgetary constraints of adding the drugs to their coverage and choose whether to opt in.
“It is potentially game changing, but it’s really difficult to be very precise about who exactly it will be game changing for,” said Juliette Cubanski, deputy director of the Program on Medicare Policy at KFF. “Certainly in the context of the Medicare program, but also in the context of Medicaid.”
Eli Lilly CEO David Ricks told reporters after the White House event that the administration plans to launch a voluntary pilot program for Medicare in the spring. While a few Medicare Part D plans may not participate, the drugmaker executive said he expects “almost all” will do so.
Then, starting in 2027, that program will become mandatory, according to Ricks.
The impact of Thursday’s announcement on people with private insurance, which is a majority of Americans, is less clear. A senior administration official said both companies have committed to lower those costs as well.
The weight-loss drugs made by Novo Nordisk and Eli Lilly, which have been greatly in demand since Wegovy was approved for weight loss in 2021, are used for a variety of conditions including helping manage blood glucose levels in people with type 2 diabetes, reducing the risk of major cardiovascular events and helping patients manage their weight.
A KFF Health Tracking Poll from May 2024 found that 12 percent of adults have reported taking a GLP-1 medication.
HHS Secretary Robert F. Kennedy Jr., who has been critical of weight-loss medications instead of lifestyle changes, said the drugs were not a silver bullet to the obesity crisis, but that the deal will help push down costs related to health conditions such as diabetes and cardiac disease.
“If we want to solve the chronic disease crisis, we have to tackle obesity,” Kennedy said.
In exchange for lower prices across government programs and TrumpRx.gov, the drugmakers will receive “certainty around tariff issues,” according to a senior administration official granted anonymity to discuss the announcement. They did not provide specific details on the tariff impacts — but other drugmakers making deals with the Trump administration investing in domestic manufacturing have gotten exemptions from tariffs that stem from investigations into the national security impacts of the pharmaceutical supply chain.
In addition, Trump said, Eli Lilly and Novo Nordisk have agreed to provide all of their other medications to Medicaid at most favored nations prices, although details were not provided.
The two drugmakers will also offer most favored nation pricing for new medicines they bring to market under the deal. The FDA also is granting the manufacturers national priority review vouchers to speed review of the new weight-loss medications.
“We do expect approval by the end of the first quarter,” Ricks said of his company’s future application for its weight loss pill. “So sometime in March perhaps, and we want it ready in time for the Medicare pilot to be introduced in the springtime.”
The new changes to Medicare coverage, which will also extend to Medicaid plans, expand eligibility to people who have severe obesity, or moderate obesity alongside other health issues like kidney disease, cardiovascular disease and uncontrolled hypertension.
A senior administration official involved in the policy rollout Thursday defined the conditions as “high metabolic risk or cardiovascular risk.”
The criteria for coverage is purposefully “a little bit more constrained” than the wider array of health concerns that the drugs are approved for, the official said. “This is not about losing weight, it is about making America healthy again. This is about preventing strokes, it’s about preventing heart attacks, and this is about preventing end stage renal disease.”
The Trump administration initially walked back a Biden-era attempt to broaden Medicare coverage of weight loss drugs. Senior administration officials called Thursday’s announcement a “better deal” because of the companies’ voluntary price drops, in exchange for expanded patient eligibility.
It’s also a politically popular move to increase access and decrease costs for some of the most rapidly sought-after drugs in the U.S.
Around six in ten adults are in favor of Medicare coverage of the drugs, a recent KFF poll found, including more than half of Democrats, independents and Republicans.
Under former President Joe Biden’s Inflation Reduction Act, Medicare has also been negotiating a separate avenue to lower the price of Novo Nordisk’s weight loss drugs Ozempic and Wegovy, which are part of the latest round of price talks. The negotiated price — known as the maximum fair price — is expected to be unveiled before the end of the month, and will be put into effect starting in 2027. It is not clear how that price will differ from the Trump-driven deal unveiled Thursday.