Pharmacy group questions how the Lilly and Novo Nordisk GLP-1 pricing deal will work
Pharmacists are asking how patients will actually get GLP-1s covered under the new pricing deals, with timing for TrumpRx, Medicaid and Medicare still unsettled.
Community pharmacy groups say important questions about the Trump administration's GLP-1 pricing agreements with Eli Lilly and Novo Nordisk remain unanswered, including whether the planned TrumpRx website will replace the manufacturers' existing direct-to-consumer programs or operate alongside them [1].
The National Community Pharmacists Association said in a Nov. 11 update that it is working with the administration to make sure any GLP-1s covered by Medicare and Medicaid can be dispensed at community pharmacies and that pharmacies are paid fairly for them. That will likely happen through a pilot program that is still being developed, NCPA said [1].
The agreements cover semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound), plus Lilly's still-in-trials oral GLP-1 orforglipron [1]. The Medicare price for the injectables will be $245 per month, and state Medicaid programs will have access to the same prices [1]. AMCP, a managed care pharmacy association, reported that the $245 price applies to all doses and indications [2].
For cash-paying customers, the manufacturers agreed to sell existing GLP-1s approved for chronic weight management on TrumpRx at an average monthly price of $350 for vials [2]. That is about 30% below the $499 per month the companies charge most patients who buy Wegovy and Zepbound through their own direct-to-consumer platforms. It is not clear whether versions with autoinjectors will be sold on TrumpRx, AMCP reported. If oral GLP-1s are approved for chronic weight management, starting doses would be priced at $150 a month [2].
In exchange, the administration plans to let Medicare cover Wegovy and Zepbound for patients with obesity and at least one related condition, with a $50 monthly copay for beneficiaries [1][2]. Medicare is generally barred by law from covering drugs for weight loss; the Biden administration proposed reinterpreting that restriction, and the Trump administration removed the proposal in the CY 2026 final rule [2].
How the drugs would reach patients
NCPA said it is discussing with the administration whether TrumpRx will act as a clearinghouse for the manufacturers' current direct-to-consumer programs or as a way for cash-paying customers to get the negotiated most-favored-nation prices. "It may ultimately be both," the group wrote [1].
AMCP reported that the administration has not given state Medicaid programs guidance on putting MFN prices in place, has not announced which specific medications fall under each agreement, and has not disclosed how MFN prices are calculated or which countries are used as references [2]. Several senators wrote to HHS Secretary Robert F. Kennedy Jr. seeking more detail on implementation [2].
The two accounts differ on timing. NCPA said TrumpRx is still being developed and will likely not be ready until some point in 2026, with a likely start for Medicaid in May 2026 and for Medicare in January 2027 [1]. AMCP reported TrumpRx is set to launch in January 2026 [2].
Other Lilly and Novo Nordisk products will have lower prices on TrumpRx, including Emgality, Trulicity, NovoLog and Tresiba [1]. AMCP listed Emgality at $299 per pen ($443 off list), Trulicity at $389 per month ($598 off list), and NovoLog and Tresiba at $35 per month of supply. AMCP said it is unclear how those discounts compare with the net prices Medicare, Medicaid or commercial plans pay [2].
Why it matters for patients
A published price matters only if a prescription can be filled. The questions pharmacists raised are about that path: whether local pharmacies will stock the products and be paid fairly, and whether patients who buy directly from the manufacturer today keep that option or are moved to a new website [1].
Medicare coverage of Wegovy and Zepbound for obesity would be new, since Medicare is generally barred from covering weight-loss drugs [2]. NCPA said the agreement gives every state Medicaid program access to MFN prices [1], while AMCP noted that 13 states currently cover GLP-1s for obesity, citing KFF [2].
AMCP also said the administration has not explained how the voluntary MFN prices interact with existing discount programs such as 340B, the Medicare Drug Price Negotiation program, or the Medicaid Drug Rebate Program, which already provides statutorily required discounts [2].
What happens next
Sources
Semaglutides.org provides information only, not medical advice. Talk to a licensed provider about your own care before making changes. Some telehealth links are affiliate links and are labeled where they appear.