Novo and Lilly also cut prices on insulin, Trulicity and Emgality

The Trump administration's most-favored-nation pricing deals with Eli Lilly and Novo Nordisk, announced November 6, 2025, extend beyond semaglutide and tirzepatide to cover other widely used drugs from the same companies ^[1][2].

Under the agreements, Lilly's Trulicity, a GLP-1 medicine for type 2 diabetes, will be offered at $389 a month through the TrumpRx platform, a discount of $598 off its list price ^[1][2]. Lilly's migraine treatment Emgality will be priced at $299 per pen, a $443 discount off list price ^[1][2]. Novo Nordisk agreed to price widely used insulin products, including NovoLog and Tresiba, at $35 a month of supply ^[1][2].

These are the same manufacturers behind Ozempic, Wegovy, Mounjaro and Zepbound, which were the headline focus of the announcement. Under the broader deal, injectable GLP-1s sold through TrumpRx will average $350 a month for vials, a 30% discount from the $499 cash price the companies already charge through their own direct-to-consumer platforms ^[1]. Medicare and Medicaid will pay $245 a month for Ozempic, Wegovy, Mounjaro and Zepbound across all doses and indications, with Medicare beneficiaries facing a $50 copay ^[1][2].

Beyond these specific price points, Lilly and Novo Nordisk also agreed to guarantee MFN prices on every new medicine either company brings to market in the future, to repatriate increased foreign revenue tied to existing products, and to make these MFN prices available to every state Medicaid program ^[1][2]. AMCP notes this marks the fourth and fifth publicly announced MFN agreements the administration has reached with drugmakers, following earlier deals with Pfizer, AstraZeneca and EMD Serono ^[1].

Why it matters for patients

For people who use Trulicity for type 2 diabetes, a $389 monthly price through TrumpRx would be a substantial cut from list price, though it is not yet clear how this compares with what insured patients already pay out of pocket under their existing drug benefits ^[1]. The same is true for Emgality, used for migraine prevention, and for insulins like NovoLog and Tresiba, which would be capped at $35 a month under the deal ^[1][2].

However, important details remain unresolved. AMCP's analysis notes the administration has not yet issued guidance to state Medicaid programs on implementing these prices, nor specified exactly which formulations or doses of each drug are covered ^[1]. It is also unclear how the discounts described in the fact sheet compare with the net prices already negotiated by Medicare, Medicaid, or commercial insurers, meaning some insured patients could see prices that differ from the headline figures depending on their specific coverage ^[1].

A group of Democratic senators, including Bernie Sanders and Elizabeth Warren, has raised concerns about how MFN pricing will interact with existing discount programs such as 340B and the Medicare Drug Price Negotiation Program, since MFN deals are voluntary and negotiated company by company rather than required by law like the Medicaid Drug Rebate Program ^[1]. The senators have also flagged a potential conflict of interest tied to Donald Trump Jr.'s board seat at BlinkRx, a direct-to-consumer pharmacy platform reported to be involved in building TrumpRx ^[1].

What happens next

The TrumpRx platform is set to launch in January 2026, according to AMCP's timeline ^[1]. Whether the administration issues formal guidance to state Medicaid programs before then, and how quickly Trulicity, Emgality and the affected insulins actually appear on the platform at the stated prices, is not yet known from these sources.