Lilly and Novo Nordisk agree to $245 monthly price for GLP-1 injectables in Medicare and Medicaid
The deals would cut the Medicare price of four GLP-1 injectables to $245 a month, but the effective date, the pricing formula and which drugs fall under each agreement have not been disclosed [1].
The Trump administration announced agreements with Eli Lilly and Novo Nordisk that set a $245 monthly price for injectable Ozempic, Mounjaro, Wegovy and Zepbound in Medicare, with the same figure offered to state Medicaid programs [1]. Ozempic and Wegovy contain semaglutide; Mounjaro and Zepbound contain tirzepatide [1].
The GLP-1 deals are the fourth and fifth the administration has struck with drugmakers, after Pfizer, AstraZeneca and EMD Serono [1]. Lilly and Novo Nordisk also agreed to price caps on insulin and other commonly prescribed diabetes medicines [1].
Medicare and Medicaid terms
The $245 figure covers every dose and every approved use of the four injectables, according to the announcement [1]. Medicare beneficiaries would pay a $50 copay for anti-obesity medications [1]. In return, the administration says it intends to let Medicare pay for Wegovy and Zepbound in patients who have obesity plus at least one related condition [1].
Federal law generally blocks Medicare from covering drugs for weight loss [1]. The Biden administration had proposed reinterpreting a section of the Social Security Act to permit coverage of anti-obesity medicines; the Trump administration withdrew that proposal in the CY 2026 final rule [1]. KFF counts 13 states that cover GLP-1s for obesity [1].
Chris Klomp, Medicare director at the Centers for Medicare and Medicaid Services, said during the announcement that manufacturers agreed to bring injectable GLP-1 prices down to the Medicare and Medicaid level over the next 24 months [1].
Cash prices and other products
Through the TrumpRx direct-to-consumer platform, the two companies agreed to sell existing GLP-1s approved for chronic weight management at an average of $350 a month for vials [1]. Lilly and Novo Nordisk currently sell most doses of Wegovy and Zepbound directly to cash-paying patients at $499 a month, making the new figure roughly 30 percent lower [1]. Whether versions that use autoinjectors would appear on TrumpRx is unclear [1].
If the FDA clears oral GLP-1s for chronic weight management, the companies agreed to set starting doses at $150 a month [1].
Lilly also committed to Emgality at $299 per pen, $443 below list price, and Trulicity at $389 a month, $598 below list [1]. Novo Nordisk agreed to supply NovoLog and Tresiba at $35 per month of supply [1]. Lilly has announced $27 billion in U.S. investment commitments, and Novo Nordisk an additional $10 billion, including domestic production of oral semaglutide [1].
Why it matters for patients
The announced numbers apply to Medicare, state Medicaid and cash purchases through TrumpRx; they do not set prices for job-based or individual commercial insurance [1]. Insured patients may still get a lower out-of-pocket cost through their plan's copay or coinsurance than through a cash platform [1].
Medicare coverage of Wegovy and Zepbound for obesity depends on the administration following through on its plan to permit it, and such use stays restricted by statute until that happens [1]. For Medicaid, each state decides whether to cover GLP-1s for weight management; access to the $245 price for all covered doses is described as a possible reason more states would do so [1].
Several pieces remain unannounced. The administration has not told state Medicaid agencies how to apply the prices, has not named the medications covered under each agreement, has not published the formula behind the prices, and has not identified the reference countries used [1]. The arrangements are voluntary and negotiated company by company, unlike the mandatory rebates states already receive under the Medicaid Drug Rebate Program [1].
Seven senators — Peter Welch, Amy Klobuchar, Ben Ray Luján, Elizabeth Warren, Jeff Merkley, Angela Alsobrooks and Bernie Sanders — wrote to Health and Human Services Secretary Robert F. Kennedy Jr. asking how the agreements will be carried out and how they interact with the 340B program and Medicare drug price negotiation [1]. Georgetown University's Center for Children and Families has published a blog on unresolved questions about fitting the prices together with the Medicaid rebate program [1]. The senators also flagged that Donald Trump Jr. joined the board of BlinkRx, a direct-to-consumer purchasing platform that The Wall Street Journal reported would be enlisted to build TrumpRx [1].
What happens next
TrumpRx is scheduled to launch in January 2026 [1]. The administration sent letters to 17 manufacturers on July 31, 2025, asking them to extend the pricing terms to every Medicaid patient and to take part in direct-to-consumer or direct-to-business distribution [1]. President Trump signed Executive Order 14297 on most-favored-nation drug pricing on May 12, 2025 [1]. No date has been disclosed for when the $245 Medicare price begins or when guidance to state Medicaid programs will arrive [1].
Sources
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