Trump's May 2025 most-favored-nation order set framework for GLP-1 price cuts

President Trump signed an executive order on May 12, 2025, titled "Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients," directing his administration to bring US drug prices in line with those paid by other developed nations. The order promised reductions of up to 59% ^[1][2][3].

The order directed the Secretary of Health and Human Services to communicate most-favored-nation (MFN) price targets to drug manufacturers and, if significant progress was not made toward those pricing structures, to propose a rulemaking plan. It also directed the secretary to facilitate direct-to-consumer purchasing programs for manufacturers selling at MFN prices ^[3].

On July 31, 2025, Trump sent letters to leading pharmaceutical manufacturers outlining the steps they must take to match the lowest price offered in other developed nations ^[2][3]. The first agreement followed on September 30, 2025, with Pfizer. According to the White House, that deal gave every state Medicaid program access to MFN prices on Pfizer products, guaranteed MFN prices on all new Pfizer medicines, required the company to repatriate increased foreign revenue, and required deep discounts on direct-to-consumer sales ^[3]. The administration also announced TrumpRx the same day, then described as a direct-to-consumer website planned for launch in "early 2026" ^[3].

On November 6, 2025, the White House announced agreements with Eli Lilly and Novo Nordisk that set the GLP-1 prices now associated with the program. Under those terms, Ozempic and Wegovy — both semaglutide, made by Novo Nordisk — would fall from $1,000 and $1,350 per month to $350 when purchased through TrumpRx. Zepbound (tirzepatide, Eli Lilly) and orforglipron, if approved, would fall from $1,086 per month to an average of $346. The initial dose of oral GLP-1 drugs was set at $150 per month ^[2].

The same announcement said Medicare prices for Ozempic, Wegovy, Mounjaro and Zepbound would be $245, with a $50 monthly copay for Medicare beneficiaries, and that the lower prices would allow Medicare to cover Wegovy and Zepbound for patients with obesity and related conditions for the first time ^[2].

TrumpRx launched on February 5, 2026, with 13 manufacturers having entered MFN agreements: Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Genentech, Gilead Sciences, GlaxoSmithKline, Merck & Co, Novartis, Novo Nordisk, Pfizer and Sanofi. No medications are sold on the site; it links out to manufacturers' websites, where patients buy directly ^[1].

Why it matters for patients

For people taking or considering GLP-1 drugs, the order's effects show up in two different prices. One is the cash price through TrumpRx: $350 a month for Ozempic and Wegovy, $346 for Zepbound, and an initial price of $150 for FDA-approved oral GLP-1 therapies ^[1]. The other is the Medicare price of $245 for Ozempic, Wegovy, Mounjaro and Zepbound, with a $50 monthly copay, which the White House said would open Medicare coverage of Wegovy and Zepbound to patients with obesity and related conditions for the first time ^[2].

TrumpRx does not accept health insurance. Purchasers must pay cash, which conflicts with some manufacturer direct-to-consumer programs that do allow insurance, and experts cautioned that some Americans could end up paying more through the site because most of the medications offered are already covered by insurance and some have cheaper generic versions ^[1].

Several effects remain unresolved. Health policy experts have noted that savings will not be realized immediately or at all, that the full details of the manufacturer deals may never be known, and that it is unclear whether the deals will remain in effect after Trump leaves office. The total impact on Medicaid programs is also uncertain, and some have raised concerns about reduced investment in biotech innovation, particularly by small and midsize companies ^[1].

What happens next

Eli Lilly has submitted a new drug application to the FDA for orforglipron after topline results from the phase 3 ATTAIN-MAINTAIN trial showed weight loss was maintained after switching from an injectable weight-loss medication. A decision date has not been reported; if approved, the lowest dose would start at $149 ^[1]. That figure was reported separately from the $150 initial-dose price for oral GLP-1 drugs announced in November 2025 ^[1][2].

As of the TrumpRx launch, 25-mg oral semaglutide (Wegovy) was the only FDA-approved GLP-1 pill for weight loss, and it is also approved to reduce the risk of major adverse cardiovascular events. GoodRx pledged in January 2026 to match Novo Nordisk's price for oral semaglutide ^[1].