Lilly agrees with the Trump administration to cut Zepbound prices

Eli Lilly announced on November 6, 2025 that it had reached an agreement with the Trump administration to lower what Americans pay for its obesity medicines. The deal sets new cash prices for Zepbound (tirzepatide) and the company's experimental pill orforglipron, promises a $50 monthly copay for some Medicare beneficiaries, and gives Lilly three years of relief from pharmaceutical tariffs ^[1][2].

What the deal sets

Under the agreement, self-pay patients will be able to buy the Zepbound multi-dose pen through LillyDirect's self-pay pharmacy channel starting at $299 for the lowest dose, with higher doses costing up to $449 — a $50 cut from current direct-to-patient prices. Lilly says refills on the LillyDirect platform will cost no more than $449 ^[1]. The company describes the new prices as "similar to what is available in Europe" ^[1].

For orforglipron, Lilly's once-daily oral GLP-1, self-pay prices would start at $149 for the lowest dose and run up to $399 — but only if and when the FDA approves it ^[1]. Lilly said it applied for a Commissioner's National Priority Voucher for the drug, which could speed the review ^[1]; BioPharma Dive reported that the FDA has awarded national priority vouchers to both orforglipron and Novo Nordisk's Wegovy ^[2].

Starting as early as April 1, 2026, Medicare beneficiaries with obesity or overweight would pay no more than $50 a month for Zepbound and for orforglipron, pending FDA approval of both in those forms ^[1]. States will also have the option to expand access through Medicaid ^[1]. BioPharma Dive reported that the government itself will pay about $245 a month for the drugs under Medicare, and that the roughly $350 monthly price applies to sales through the new TrumpRx government portal ^[2].

These numbers sit against a list price of $1,080 a month for Zepbound and $1,350 for Wegovy, and against the $499 a month both companies have been charging on their direct-to-consumer sites ^[2]. Comparisons get murkier against "net" prices after insurer negotiations: Leerink Partners analyst David Risinger estimated the $245 Medicare figure is about 55% of current Medicaid and Medicare net prices ^[2].

Lilly also said it will add Mounjaro (tirzepatide), Trulicity (dulaglutide) and Emgality (galcanezumab-gnlm) to LillyDirect for self-pay patients at 50% to 60% off current list prices, and will keep capping insulin at $35 a month ^[1]. In return, the company receives three years of tariff relief and will not be subject to future pricing mandates ^[1].

Why it matters for patients

The biggest caveat is who is left out. Lilly stated plainly that "the scope of the agreement does not include pricing obligations in the commercial channel" ^[1]. Risinger's team estimated that average commercial plans pay roughly $450 to $500 a month for Zepbound, and reported that Lilly said it "does not have any obligations" to cut those prices, though it expects them to come down over time ^[2]. So most people with employer or marketplace coverage may see no direct change from this deal.

The Medicare piece also comes with strings. BioPharma Dive reported that the Medicare price will be delivered through a pilot program, which Novo Nordisk said would cover most beneficiaries — a structure that may be necessary because the law authorizing Medicare drug coverage specifically bars weight-loss products. That design likely limits which beneficiaries qualify and could carry a fixed expiration date ^[2]. Exactly who will be eligible is not yet spelled out in these sources.

Lilly said the changes would improve access for nearly 40 million Americans with obesity on government insurance programs plus millions who pay cash ^[1], and Risinger wrote that Lilly believes 40 million more Americans will become eligible for treatment with its obesity drugs ^[2].

What happens next

The Medicare $50 copay is slated to begin "as early as" April 1, 2026 ^[1]. The orforglipron prices depend on FDA approval, which has not happened yet ^[1]. Novo Nordisk expects a "low single-digit impact" on its 2026 global sales growth when the new prices take effect; Lilly did not say how its own sales might be affected ^[2].