Lilly and Novo Nordisk agree to $245 monthly GLP-1 prices for Medicare and Medicaid

The White House said Nov. 6 that Eli Lilly and Novo Nordisk agreed to "most-favored-nation" pricing for their GLP-1 medicines, setting Medicare and Medicaid prices at $245 a month for Ozempic, Wegovy, Mounjaro and Zepbound, with a $50 monthly copay for Medicare beneficiaries ^[1][2]. The deals also allow Medicare to cover obesity drugs for the first time ^[1].

What the prices are

The White House fact sheet says cash prices on TrumpRx, a federal direct-to-consumer site the administration says it will launch in January, would be $350 a month for Ozempic and Wegovy, down from $1,000 and $1,350 respectively ^[1]. Zepbound and orforglipron, Lilly's experimental pill, would fall from $1,086 a month to an average of $346, if orforglipron is approved ^[1].

A senior administration official told reporters that starting doses of existing injections such as Wegovy and Zepbound would be $350 a month on TrumpRx and would "trend down" to $245 over about two years ^[2].

The two accounts differ slightly for oral drugs. The White House fact sheet says the initial dose of an approved Wegovy pill, or similar oral GLP-1s from either company, would be priced at $150 a month through TrumpRx ^[1]. The administration official said starting doses of upcoming obesity pills would be $149 a month for people getting them through Medicare, Medicaid or TrumpRx ^[2].

Separately, Lilly said it would cut prices by $50 on its own LillyDirect platform, listing the Zepbound multidose pen at $299 a month at the lowest dose, with higher doses up to $449 a month, and orforglipron at $149 a month at the lowest dose once approved ^[2].

The agreement also covers other medicines: Emgality at $299 per pen, a discount of $443 off list price; Trulicity at $389 a month, a discount of $598; and Novo Nordisk insulins including NovoLog and Tresiba at $35 per month of supply ^[1]. The companies also committed to manufacturing investments, with Novo Nordisk adding $10 billion and Lilly announcing at least $27 billion in new U.S. manufacturing ^[1].

Who is covered

The $245 Medicare price applies to all approved uses, not just weight loss ^[2]. An administration official said about 10% of Medicare beneficiaries would be eligible, in three groups: people with a BMI above 27 who have prediabetes or established cardiovascular disease; people with a BMI above 30 plus uncontrolled hypertension, kidney disease or heart failure; and people with a BMI above 35 ^[2]. The official described the approach as constraining access for patients who will benefit clinically, balancing broad access ^[2].

All 50 state Medicaid programs can get the $245 price for all covered uses, but states have to opt in, so some may not ^[2]. STAT reported that the precise timeline for the coverage expansion and how many people will actually gain access remain unclear ^[4].

Commercial insurance is less settled. STAT reported that commercial plans will also receive discounts ^[4], and Health and Human Services Secretary Robert F. Kennedy Jr. said at a briefing that "all Americans, even those who are not on Medicaid, Medicare, are going to be able to get the same price for their drugs, for their GLP-1s" ^[2]. How employer and individual market pricing would change has not been detailed in the announcements.

Lilly CEO David Ricks called the deal "a pivotal moment in U.S. health care policy" ^[2]. Novo Nordisk CEO Mike Doustdar said the announcement "will bring semaglutide medicines to more American patients at a lower cost" ^[2].

Why it matters for patients

List prices for these drugs have run roughly $1,000 to $1,350 a month before insurance, a barrier that has kept many patients from starting or staying on treatment ^[2]. The deal changes two separate things: what the government pays, and who is eligible for coverage. Medicare covers about 66 million people and is the main insurer for adults 65 and older, so its new obesity coverage could reach a large group that previously paid cash or went without ^[2].

Eligibility is narrower than the drugs' FDA labels. GLP-1s for weight loss are approved for people with obesity or those who are overweight with one related condition, while the Medicare groups described by the administration use specific BMI thresholds combined with other conditions ^[2]. Medicaid coverage will vary by state because participation is voluntary ^[2].

Semaglutide is also included in the next round of Medicare drug price negotiations under the Inflation Reduction Act, and the administration is expected to release prices for 15 selected drugs by Nov. 30 ^[2]. Tirzepatide is not expected to be eligible for those talks until the end of the decade ^[2].

What happens next

TrumpRx is scheduled to launch in January, and Medicare coverage of obesity drugs is expected to start in mid-2026 ^[2]. Novo Nordisk's oral Wegovy could reach the market by the end of this year and Lilly's orforglipron next year, both pending FDA approval; the FDA said Nov. 6 that it granted priority review vouchers that speed review of Lilly's pill ^[2].