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

On Nov. 6, 2025, the Trump administration announced agreements with Eli Lilly and Novo Nordisk to sell the GLP-1 drugs semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) at most-favored-nation (MFN) prices ^[1]. The deals also cover insulin, the diabetes drug Trulicity and the migraine drug Emgality, and guarantee MFN prices on all new medicines the two companies bring to market ^[1][2].

The announced prices

Cash-paying patients would buy vials of the weight-management versions of these drugs through the TrumpRx platform at an average of $350 a month ^[1]. Both companies currently sell most doses of Wegovy and Zepbound directly to eligible cash-paying patients for $499 a month, so the TrumpRx price is about a 30% discount ^[1].

The White House described the change as a drop from list prices: Ozempic from $1,000 a month to $350, Wegovy from $1,350 to $350, and Zepbound and orforglipron, an Eli Lilly oral GLP-1 that is not yet approved, from $1,086 a month to an average of $346 ^[2]. If the FDA approves oral GLP-1 drugs for chronic weight management, the companies agreed to price starting doses at $150 a month on TrumpRx ^[1][2].

For Medicare and Medicaid, injectable Ozempic, Mounjaro, Wegovy and Zepbound would be priced at $245 a month, applying to all doses and indications ^[1]. The White House said state Medicaid programs would also have access to that price ^[2]. Medicare beneficiaries would pay a $50 monthly copay ^[1][2]. The administration said the lower prices would let Medicare cover Wegovy and Zepbound for patients with obesity and at least one related condition for the first time ^[1][2]. Medicare is legally barred from covering drugs for certain uses, including weight loss; the Biden administration proposed reinterpreting part of the Social Security Act to allow coverage of anti-obesity medicines, and the Trump administration removed that proposal in the 2026 policy and technical changes final rule ^[1]. Currently 13 states cover GLP-1s for obesity, according to KFF ^[1].

Also announced: Emgality at $299 per pen, a discount of $443 off list price; Trulicity at $389 a month, $598 off list price; and Novo Nordisk insulins including NovoLog and Tresiba at $35 per month of supply ^[1][2].

What has not been disclosed

It is unclear whether the companies will sell versions with autoinjectors on TrumpRx, and how these discounts compare with the net prices Medicare, Medicaid or commercial plans already pay; people with insurance may get a better out-of-pocket price through their own coverage ^[1]. The administration has not given state Medicaid programs guidance on implementing MFN prices, has not listed the specific medications covered under each agreement, and has not published the formula used to set MFN prices or the reference countries used ^[1]. Seven senators sent a letter to Health and Human Services Secretary Robert F. Kennedy Jr. seeking details and raising questions about how MFN prices interact with the 340B program and Medicare drug price negotiation ^[1].

Chris Klomp, director of Medicare at the Centers for Medicare and Medicaid Services, said at the press conference that manufacturers agreed to bring injectable GLP-1 prices down to the Medicare and Medicaid level over the next 24 months ^[1]. Novo Nordisk committed an additional $10 billion to expand its U.S. manufacturing, including production of an oral semaglutide if approved; Eli Lilly has announced at least $27 billion in U.S. manufacturing investments since Trump took office ^[1][2].

Why it matters for patients

The announced cash price of about $350 a month is below the $499 a month the two companies charge cash-paying patients today, and the $245 Medicare price applies to every dose and every approved use of the four injectable products ^[1][2]. For Medicare beneficiaries who qualify, the copay would be $50 a month, and the coverage would extend to people with obesity plus a related condition ^[1][2]. Medicaid programs would also get the $245 price for covered doses ^[1].

Several practical questions remain open. The $245 Medicare price applies to injectable forms only, and the timing for reaching it was described as up to 24 months ^[1]. Orforglipron and an oral Wegovy are not approved for chronic weight management, so the $150 starting-dose price and the oral-drug figures are contingent on FDA decisions ^[1][2]. Seniors and state Medicaid programs have no published implementation guidance yet ^[1].

What happens next

TrumpRx is set to launch in January 2026 ^[1]. The agreements follow Executive Order 14297, signed May 12, 2025, and letters sent to 17 manufacturers on July 31, 2025 ^[1]. The White House said the Nov. 6 announcement was the fifth such deal since Sept. 30, 2025 ^[2]. No date has been announced for when the $245 Medicare price takes effect or when the $50 copay begins ^[1].