Novo Nordisk and Eli Lilly win tariff relief and fast-track vouchers in GLP-1 pricing deal

The Trump administration announced a pricing agreement with Novo Nordisk and Eli Lilly on November 6, 2025 that lowers prices for GLP-1 weight-loss drugs in Medicare, Medicaid and cash purchases, and gives both companies relief from pharmaceutical tariffs plus fast-track regulatory vouchers for future medicines ^[1].

Under the deal, monthly prices for the injectable GLP-1s already sold for diabetes and other covered conditions would fall to $245 for people covered by Medicare or Medicaid ^[1]. Starter doses of the weight-loss pills the two companies are developing — Novo's once-daily oral Wegovy and Lilly's orforglipron — would cost $149 a month for all Medicare and Medicaid enrollees and through the White House's direct-to-consumer site, TrumpRx, if regulators approve them ^[1].

For cash payers, Lilly said the lowest dose of Zepbound would cost $299 a month and higher doses $449 a month ^[1]. On TrumpRx, the average price of injectable and pill GLP-1s will start at or below $350 a month and is expected to fall toward $245 within two years, administration officials said ^[1]. Medicare enrollees' co-pays would be capped at $50 a month, and commercial insurers would be able to buy at prices estimated at 25 percent below current cash prices ^[1]. Wegovy and Zepbound currently list for more than $1,000 a month, though both companies offer cash buyers a $499 monthly supply ^[1].

The agreement also widens who qualifies for coverage. Officials said it covers overweight patients with prediabetes or heart problems, obese patients with other health conditions and severely obese patients, a group they said accounts for 10 percent of Medicare patients ^[1]. Medicare does not typically cover the drugs for obesity now, and Medicaid coverage varies by state ^[1].

Timing depends on the payer. The agreed prices take effect no later than January for cash payers, by mid-2026 for Medicare and on an ongoing basis for Medicaid as states sign up ^[1].

The deal also covers tariffs and regulatory rewards. Administration officials said the companies would receive relief from pharmaceutical tariffs, with Lilly exempted for three years, and that both would get fast-track regulatory vouchers for some future medicines; the officials did not say which medicines ^[1]. Novo committed to an additional $10 billion investment in the United States, according to a White House fact sheet ^[1]. Lilly said it would add its diabetes medicines Emgality, Trulicity and Mounjaro to its direct-to-consumer platform at 50 to 60 percent below current list prices, and that the agreement improves access for nearly 40 million Americans covered by government insurance programs ^[1].

Novo Nordisk shares fell 3.6 percent and Eli Lilly shares were nearly flat, up 0.03 percent, as of 2 p.m. in New York on the day of the announcement ^[1]. Deutsche Bank analysts estimated that a $150 monthly cap applied to orforglipron could open access to as many as 15 million Americans, and that about 20 percent of adults with obesity would prefer pills to injections; about 2.7 million Americans take Zepbound ^[1].

The GLP-1 drugs covered by the agreement are semaglutide, sold as Ozempic and Wegovy, and tirzepatide, sold as Zepbound and Mounjaro. Direct-to-consumer prices for Ozempic and Wegovy are set to fall under the arrangement ^[2].

Why it matters for patients

For someone paying cash, the announced Zepbound prices of $299 to $449 a month are below the $499 monthly cash supply the company offers now ^[1]. For Medicare enrollees, the $50 co-pay cap and the new coverage categories matter because Medicare generally does not cover these drugs for obesity today ^[1]. Medicaid works differently: each state runs its own program and has to sign up, so prices and timing will vary by state ^[1]. The announcement did not say whether commercial insurers would pass their discounted prices on to members ^[1]. The $149 price for the experimental pills depends on FDA approval, which has not happened ^[1].

What happens next

Cash prices are to begin no later than January, Medicare prices by mid-2026 and Medicaid as states join ^[1]. The FDA is reviewing Novo's once-daily oral Wegovy, with a decision expected later this year, while Lilly plans to submit orforglipron for review by the end of the year and a possible launch in 2026 ^[1]. The agreement secures a fast-tracked FDA review of a higher-dose Wegovy, and Novo has said the lower prices could weigh on its global sales growth ^[2]. How Medicare's expanded coverage will be written into plan rules, and which future drugs the vouchers apply to, has not been reported ^[1].