President Donald Trump said Thursday his administration has reached a deal to lower the cost of the blockbuster GLP-1 weight loss drugs, Wegovy and Zepbound — a move that could significantly expand access to the wildly popular drugs, though some details remained unclear.
Under the deal, the monthly out-of-pocket cost of the drugs could range from $50 to around $350, depending on the dosage and insurance coverage.
Currently, Eli Lilly's Zepbound and Novo Nordisk's Wegovy carry list prices above $1,000 a month, although both companies have introduced lower cost options for patients paying in cash and purchasing the drugs directly through their websites. To further expand access, Costco recently announced it would sell Wegovy and Ozempic for $499 for people who paid cash, while Walmart launched a similar arrangement with Lilly’s Zepbound.
People whose insurance covers the drugs usually pay much less than the list price. However, many insurers do not cover them.
The agreements could make the popular treatments more affordable for millions who have struggled to access them — although experts say it remains unclear who would immediately benefit, since some of the drugs are already covered for Medicare patients with certain medical conditions and the new costs remain high for many patients.
“The details are totally obscure and it’s a little hard to predict: Will it help or won’t it help?” said Art Caplan, the head of the Division of Medical Ethics at NYU Langone Medical Center in New York City.
“The price reduction is important, and the manufacturers seem willing, but they’re still very expensive,” Caplan said.
It’s unclear whether people on Medicare who need the drugs for weight loss alone would benefit. Medicare is barred from covering drugs that treat weight loss alone.
During a White House briefing, Trump said Medicare and Medicaid “will finally cover the cost of the weight loss drugs for millions of patients suffering from obesity.”
On TrumpRx — the government’s discount platform for buying prescription drugs with cash — the average monthly cost for Wegovy and Zepbound will start at $350 and drop to $250 within the next two years, according to senior administration officials.
Medicare and Medicaid cover GLP-1 drugs for diabetes and some other medical conditions. These drugs include Novo Nordisk’s Ozempic and Lilly’s Zepbound.
The drugmakers have voluntarily agreed to reduce the prices the government pays for all GLP-1 drugs already approved for diabetes and other indications to $245 a month across all non-starting doses. People on Medicare will pay no more than a $50 copay. People on Medicaid typically do not pay a copay.
Both drugmakers will get relief from pharmaceutical tariffs for three years.
The administration expects the direct-to-consumer pricing to be available by the end of the year on the TrumpRx site and Medicare coverage to be available by the middle of next year.
The deal is part of Trump’s “most favored nation” push, an effort by the president to lower prescription drug prices and bring them more in line with other developed nations. Trump revived the initiative through an executive order in May after unsuccessfully pursuing it during his first term.
Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said she has questions about how the plan would work next year, since Medicare has already set premiums and copays for 2026.
She added that it’s also unclear how many people would be able to access the drugs under the new deal. Medicare already covers Wegovy for patients with heart disease risk and Zepbound for sleep apnea, but not for weight loss alone. Ozempic is covered for diabetes.
“It’s not totally clear to me how expansive this is,” she said, adding that $250 to $350 a month is still a lot of money for many people.
“The good news is that people who want to use these medications and have the money can access them through direct-to-consumer avenues,” she said.
Juliette Cubanski, deputy director of the Medicare policy program at KFF, a nonpartisan health policy research, said she had questions about how the administration proposes to change Medicare coverage to include drugs for weight loss.
“Will this be a voluntary expansion or will plans be required to cover these drugs for people with obesity or overweight?,” Cubanski said. “How does the administration propose to get around the current statutory prohibition against Medicare coverage of weight loss drugs?
In a statement, Novo said Medicare coverage for weight loss drugs would be enabled through a pilot program, but did not provide further details.
On an earlier call with reporters, senior administration officials said people on Medicare and Medicaid will be eligible for coverage if they are overweight or obese and meet certain criteria, such as having heart disease, kidney disease or severe obesity. Around 10% of Medicare enrollees, the officials said, will be eligible for coverage under those criteria.
Meanwhile, the deal mentioned that starting doses of GLP-1 pills will cost $149. No GLP-1 pills for weight loss have been approved, although Novo Nordisk and Lilly are studying these formulations. Lilly said it has applied for a “priority voucher,” which would expedite the approval of a weight loss pill. A senior official said the administration expects that priority voucher will be approved Thursday.
The administration has also reached similar pricing agreements with Pfizer and AstraZeneca to reduce costs for certain prescription drugs covered under Medicaid.
The Biden administration previously proposed expanding Medicare and Medicaid coverage for GLP-1 drugs, but the Trump administration later rejected that plan.
Ozempic and Wegovy are also among the drugs selected for the next round of Medicare price negotiations under the Inflation Reduction Act, which President Joe Biden signed into law in 2022. The Trump administration was expected to finalize new prices for 15 drugs — including the GLP-1s — by Nov. 1, but officials have shown less enthusiasm for the formal negotiation process, focusing instead on executive orders and voluntary pricing agreements with manufacturers. The administration is expected to unveil the new prices by Nov. 30.
Trump’s deal Thursday is not part of the Medicare drug pricing negotiations.
