Questions swirl after Trump’s GLP-1 pricing deal announcement

At a White House event on Thursday, President Trump announced new deals with drug makers Novo Nordisk and Eli Lilly to offer their popular GLP-1 obesity and diabetes drugs at lower prices for certain Americans, specifically some individuals on Medicare and Medicaid plans. However, questions remain about the overall significance of this deal.

According to the announcement, Medicare and state Medicaid programs will be able to purchase a month’s supply of Ozempic, Wegovy, Mounjaro, and Zepbound at $245 each for eligible patients. Those eligible on Medicare will face a $50 co-pay for the medications.

This negotiated price represents a significant discount compared to the drugs’ list prices: Ozempic at $997, Wegovy at $1,350, Mounjaro at $1,080, and Zepbound at $1,086. However, it’s important to note that purchasers rarely pay the full list price. It remains unclear what Medicare and Medicaid would have paid for these drugs without this deal and what the actual savings will be.

Additionally, it is uncertain how many people within these federal programs will gain access to the drugs at the newly negotiated prices. Currently, federal programs are prohibited from covering any drugs intended solely for “weight loss.” The Biden administration previously proposed a reinterpretation of this federal rule to allow coverage of drugs specifically for obesity treatment, which would have enabled approximately 3.4 million people on Medicare and about 4 million on Medicaid to access such medications. However, the Trump administration rejected this change.

The administration stated that the new drug pricing will be available to Medicare and Medicaid patients who meet specific conditions. The drugs at their new prices will be accessible to:

– Individuals with a body mass index (BMI) over 27 who have also been diagnosed as pre-diabetic or have had a stroke, myocardial infarction, or peripheral artery disease;

– Individuals with a BMI over 30 who also suffer from stage-three kidney disease or other qualifying comorbidities;

– Individuals with a BMI over 35.

While some patients may gain access under these categories, assessing the deal’s impact becomes more complex considering that millions are expected to lose federal health coverage under the Trump administration’s “One Big Beautiful Bill Act.”

### Unmatched Prices and Direct-to-Consumer Options

In addition to deals for federal programs, the administration announced new direct-to-consumer prices. Currently, individuals with prescriptions can purchase the most popular drugs, Wegovy and Zepbound, directly from Novo Nordisk and Eli Lilly respectively for $499 each.

Under the new deal, Wegovy and Ozempic will be available for $350, and Zepbound will be priced at an average of $346. Although these prices are lower, out-of-pocket costs will still likely be higher than what most insured individuals would pay through their insurance plans. Moreover, purchasing these drugs outside insurance coverage means such payments will not count toward out-of-pocket maximums or other insurance tallies.

Generally, experts expect that direct-to-consumer sales will not significantly impact overall drug costs. It also remains unclear whether Trump’s deal will influence GLP-1 drug prices for those with commercial insurance plans.

### Comparison to International Prices

President Trump referred to the deals as “most favored-nation pricing.” Still, even with these lowered prices for some Americans, U.S. consumers continue to pay more than their foreign counterparts.

Senator Bernie Sanders (I-Vt.) highlighted last year that while Novo Nordisk set Ozempic’s list price at nearly $1,000 in the U.S. and the new deal reduces it to $245, the drug costs just $155 in Canada, $122 in Italy, $71 in France, and $59 in Germany. Wegovy ranges from $186 in Denmark to $92 in the United Kingdom. Eli Lilly’s Mounjaro is priced at $94 in Japan.

A 2023 study published in *JAMA Network Open* by researchers at Yale estimated that the manufacturing costs for this class of drugs are under $5 for a month’s supply.

### Future GLP-1 Pills and Pricing

The announcement also mentioned that future GLP-1 drugs in pill form, rather than injections, from the two companies will be priced at $150 for both federal programs and direct-to-consumer sales. While such pills are nearing market approval, none are currently available or approved by the Food and Drug Administration (FDA).

Since these pills are not yet on sale, the potential cost savings from this part of the deal remain unknown.

In summary, while the Trump administration’s recent announcement may reduce prices for some Americans on federal programs, the actual impact on broader access and overall drug costs is uncertain. Many questions remain regarding coverage restrictions, the number of eligible patients, and the comparison of costs to both international prices and typical insured patient expenses.
https://arstechnica.com/health/2025/11/questions-swirl-after-trumps-glp-1-pricing-deal-announcement/

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