President Donald Trump said Thursday that his administration has agreed to lower the prices of the blockbuster GLP-1 weight loss drugs Wegovy and Zepbound. It’s a move that could greatly expand access to popular drugs, but some details are unclear.
Depending on your contract, your monthly out-of-pocket cost for a drug can range from $50 to about $350, depending on dosage and insurance coverage.
Currently, Eli Lilly’s Zepbound and Novo Nordisk’s Wegovy keep their list prices above $1,000 per month, but both companies have introduced cheaper options that allow patients to pay with cash and purchase the drugs directly through their websites. To further expand accessibility, Costco recently announced it would sell Wegovy and Ozempic for $499 for those paying cash, and Walmart launched a similar deal with Lilly’s Zepbound.
People with drug insurance typically pay much less than the list price. However, many insurance companies do not cover this.
The agreement could make popular treatments more affordable for millions of people who struggle to access them. But experts say it’s unclear who will benefit immediately because some drugs are already covered for Medicare patients with certain conditions and the new costs remain high for many patients.
“The details are completely vague and a little hard to predict. Will it help or not?” said Art Caplan, director of the medical ethics department at NYU Langone Medical Center in New York City.
“Price reductions are important and manufacturers seem willing to do so, but they are still very expensive,” Caplan said.
It’s unclear whether people with Medicare who only need the drug for weight loss would be covered. Medicare is prohibited from covering drugs that only treat weight loss.
President Trump said at a White House briefing that Medicare and Medicaid “will finally cover the cost of weight loss medications for the millions of patients suffering from obesity.”
On TrumpRx, a government discount platform that allows people to buy prescription drugs with cash, the average monthly cost of Wegovy and Zepbound will start at $350 and fall to $250 within the next two years, according to a senior government official.
Medicare and Medicaid cover GLP-1 drugs for diabetes and some other diseases. These drugs include Novo Nordisk’s Ozempic and Lilly’s Zepbound.
Pharmaceutical companies have already voluntarily agreed to lower the price the government pays for all GLP-1 drugs approved for diabetes and other indications to $245 per month across all non-starting doses. People with Medicare pay a copay of up to $50. People with Medicaid typically pay no out-of-pocket costs.
The two pharmaceutical companies will be exempted from drug tariffs for three years.
The administration expects direct-to-consumer pricing to be available on the TrumpRx site by the end of the year and Medicare coverage to be available by the middle of next year.
The deal is part of President Trump’s “Most Favored Nation” policy to lower prescription drug prices and bring them more in line with other developed countries. Trump failed to pursue this plan during his first term, but revived it through an executive order last May.
Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said there are questions about how the plan will work next year because Medicare has already set premiums and copays for 2026.
She added that it is also unclear how many people will have access to the drugs under the new contract. Medicare already covers Wegovy for patients at risk for heart disease and Zepbound for sleep apnea, but not just for weight loss. Ozempic is covered for diabetes.
“It’s not entirely clear to me how widespread 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 try these drugs and have the money can access them through direct-to-consumer channels,” she said.
Juliette Cubanski, deputy director of the Medicare Policy Program at KFF, a nonpartisan health policy research organization, said she has questions about how the administration proposes to change Medicare coverage to include drugs for weight loss.
Cubanski said, “Will this be a voluntary expansion, or will we need a plan to cover these drugs for people who are obese or overweight?” “How does the administration propose to circumvent the current statutory ban on Medicare coverage of weight loss drugs?
Novo said in a statement that Medicare coverage of the weight-loss drug would be activated through a pilot program, but did not provide further details.
In an earlier call with reporters, a senior administration official said people with Medicare and Medicaid would be eligible for coverage if they are overweight or obese and meet certain criteria, such as heart disease, kidney disease or severe obesity. Officials said about 10% of Medicare enrollees would be eligible for coverage under these criteria.
Meanwhile, the deal noted that the starting dose of GLP-1 pills will cost $149. GLP-1 pills for weight loss have not been approved, although Novo Nordisk and Lilly are researching such formulations. Lilly said it had applied for a “priority voucher” to expedite approval of its weight-loss drug. A senior official said the administration expects the priority vouchers to be approved Thursday.
The administration also struck similar pricing deals with Pfizer and AstraZeneca to reduce costs for certain prescription drugs covered by Medicaid.
The Biden administration previously proposed expanding Medicare and Medicaid coverage of GLP-1 drugs, but the Trump administration later rejected the plan.
Ozempic and Hugobee are also among the drugs selected for the next phase of Medicare pricing 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 GLP-1, by Nov. 1, but officials have shown less enthusiasm for a formal negotiation process, focusing instead on executive orders and voluntary pricing agreements with manufacturers. The government is expected to release new prices by November 30.
Trump’s deal Thursday was not part of the Medicare drug price negotiations.
