Federal pricing agreement sets Mounjaro at $245 a month for Medicare and Medicaid
The White House says Eli Lilly and Novo Nordisk will sell injectable GLP-1s, including Mounjaro, to Medicare and state Medicaid programs for $245 a month, with a $50 copay for obesity drugs [1].
President Donald Trump announced a set of agreements with Eli Lilly and Novo Nordisk to bring "most-favored-nation" (MFN) pricing to GLP-1 medicines, setting a $245 monthly price for injectable Ozempic, Mounjaro, Wegovy and Zepbound for Medicare [1]. The same $245 price would also be offered to state Medicaid programs for all covered doses [1].
According to an analysis from the Academy of Managed Care Pharmacy, the $245 Medicare price applies to all doses and all indications — so it covers tirzepatide sold as Mounjaro for type 2 diabetes as well as the higher-dose weight-management products [1]. Ozempic and Wegovy are semaglutide; Mounjaro and Zepbound are tirzepatide [1].
In exchange, the administration says it plans to enable Medicare coverage of Wegovy and Zepbound for people with obesity and at least one related health condition, with Medicare beneficiaries paying a $50 copay for anti-obesity medications [1]. That is a meaningful shift, because Medicare is barred by statute from covering drugs used for weight loss [1]. The Biden administration had proposed reinterpreting section 1927(d)(2) of the Social Security Act to allow coverage of anti-obesity medications, but the Trump administration removed that proposal from the CY 2026 Policy and Technical Changes Final Rule [1].
The cash-pay side
Separately, the manufacturers agreed to sell existing GLP-1s indicated for chronic weight management on the government's TrumpRx platform at an average of $350 a month for vials [1]. Both companies currently sell most doses of Wegovy and Zepbound directly to eligible cash-paying patients for $499 a month through their own platforms, so $350 would be about a 30% discount [1]. It is not clear whether versions with autoinjector pens — rather than vials — would be sold on TrumpRx [1].
If the FDA approves oral GLP-1s for chronic weight management, the companies agreed to price starting doses at $150 a month [1]. Chris Klomp, Director of Medicare at the Centers for Medicare & Medicaid Services, said at the press conference that manufacturers have agreed to lower the price of injectable GLP-1s to the same level offered to Medicare and Medicaid over the next 24 months [1].
Other diabetes-related products were included: Lilly's Trulicity, another GLP-1 used for diabetes, at $389 a month (a $598 discount off list), Lilly's migraine drug Emgality at $299 per pen, and Novo Nordisk insulins including NovoLog and Tresiba at $35 per month of supply [1].
Why it matters for patients
For people on Medicare, the practical question has been coverage, not just price. Today most Medicare drug plans cannot cover GLP-1s prescribed purely for weight loss [1]. The announced arrangement pairs a lower government price with a plan to open coverage for Wegovy and Zepbound in people with obesity plus a comorbidity, at a $50 copay [1].
On the Medicaid side, only 13 states currently cover GLP-1s for obesity, according to KFF data cited in the analysis [1]. Lower upfront costs could push more states to add coverage, but that decision stays with each state [1].
Important details remain unsettled. The administration has not issued guidance to state Medicaid programs on implementing MFN prices, has not listed the specific medications covered under each agreement, and has not explained the formula or the reference countries used to calculate MFN prices [1]. A group of senators led by Peter Welch (D-VT), along with Amy Klobuchar (D-MN), Elizabeth Warren (D-MA), Bernie Sanders (I-VT) and others, wrote to HHS Secretary Robert F. Kennedy Jr. seeking implementation details and flagging questions about how MFN prices interact with 340B, the Medicare Drug Price Negotiation program and the Medicaid Drug Rebate Program [1]. Unlike those statutory programs, the MFN deals are voluntary and negotiated company by company [1].
What happens next
The TrumpRx platform is set to launch in January 2026 [1]. Klomp's 24-month timeline points to injectable GLP-1 prices converging with the Medicare and Medicaid level over roughly the next two years [1]. The source material for this report does not describe a "Medicare GLP-1 Bridge" program or a July 2026 start date, so those specifics are not yet confirmed here [1].
Sources
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