The Trump administration, Novo Nordisk, and Eli Lilly have agreed to a pricing framework that will lower the cost of GLP‑1 obesity drugs and broaden Medicare and Medicaid coverage for 2026. The agreement sets a $50 copay for Medicare beneficiaries on all approved uses of injectable and oral GLP‑1 medications and introduces TrumpRx.gov, a direct‑to‑consumer platform that will offer the drugs at $149 per month for new oral pills once approved.
Under the framework, the lowest dose of Wegovy will be $149 per month on TrumpRx, while Zepbound will be $299 per month. For Medicare, Medicaid, and TrumpRx users, the starting dose of all GLP‑1 drugs will be $149 per month, with other doses for diabetes and other indications priced at $245 per month. The agreement also caps the price of Ozempic, Wegovy, Mounjaro, and Zepbound at $245 for Medicare beneficiaries, translating into a $50 copay.
Medicare coverage for the drugs is expected to begin in the middle of 2026, with Medicaid coverage slated for April 2026 for eligible patients. TrumpRx.gov is scheduled to launch in January, providing a streamlined purchasing channel that bypasses traditional pharmacy benefit managers.
The deal comes as Novo Nordisk’s oral Wegovy is awaiting an FDA decision expected in late 2025, with a commercial launch planned for early 2026. Eli Lilly’s oral Orforglipron is on track to submit for regulatory approval by the end of 2025, with potential market entry in 2026.
Novo Nordisk’s Q3 2025 earnings revealed an EPS of $0.70 versus an estimate of $0.77 and revenue of $11.74 billion against an estimate of $11.88 billion. The miss was driven by intensified competition from Eli Lilly, the availability of compounded versions of the drugs, and higher research and development costs. Management trimmed its 2025 sales and profit outlook in response to a slowdown in GLP‑1 demand and rising R&D expenses. The Diabetes and Obesity Care segment saw sales rise 11% year‑over‑year, while the Rare Disease segment grew 9%.
The pricing agreement is a significant policy shift that could reshape the obesity drug market. By expanding Medicare and Medicaid coverage, the deal opens a large patient base that was previously excluded, potentially increasing volume for both Novo Nordisk and Eli Lilly. The structure of the pricing framework, which sets lower prices for injections and oral pills, may advantage Lilly, whose oral product is expected to launch earlier. The direct‑to‑consumer platform is designed to reduce costs associated with pharmacy benefit managers and could set a new benchmark for drug pricing negotiations.
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