White House deal sets $245 Medicare price and TrumpRx pricing for GLP-1s

President Donald Trump announced agreements on November 6, 2025 with Eli Lilly and Novo Nordisk to cut the prices of GLP-1 medications for Medicare, Medicaid and cash-paying patients, and to let Medicare cover obesity drugs for the first time ^[3]. The deals are the fourth and fifth publicly announced "most-favored-nation" (MFN) pricing agreements between the administration and drugmakers, following Pfizer, AstraZeneca and EMD Serono ^[1].

Under the agreement, Medicare will pay $245 per month for injectable Ozempic, Wegovy, Mounjaro and Zepbound, a price the White House says applies across doses and indications and that state Medicaid programs can also access ^[1][3]. Medicare beneficiaries would pay a $50 monthly copay ^[3]. CNBC reported that the $50 copay applies to all approved uses of injectable and oral GLP-1 drugs, including diabetes and obesity ^[4].

For people paying cash, the companies agreed to sell weight-management GLP-1s on TrumpRx, a government website set to launch in January 2026 ^[1][4]. The White House says Ozempic and Wegovy prices fall from about $1,000 and $1,350 per month to $350, and Zepbound (plus orforglipron, if approved) from $1,086 to an average of $346 ^[3]. AMCP notes the $350 figure refers to vials and represents roughly a 30% discount from the $499 monthly price the manufacturers already charge cash-paying patients on their own platforms; it is not yet clear whether autoinjector versions will be sold on TrumpRx ^[1]. A senior administration official said TrumpRx injection prices would "trend down" to $245 over two years ^[4], echoing a comment from CMS Medicare Director Chris Klomp that manufacturers agreed to match the Medicare and Medicaid price within 24 months ^[1].

If the FDA approves oral GLP-1s for chronic weight management, starting doses are to be priced at $150 per month on TrumpRx ^[1][3]; CNBC reported an official citing $149 per month for starting doses across Medicare, Medicaid and TrumpRx ^[4]. Separately, Lilly said it would cut LillyDirect self-pay prices by $50, putting the Zepbound multi-dose pen at $299 for the lowest dose and up to $449 for higher doses, if FDA approved ^[2][4]. The deals also cover insulins NovoLog and Tresiba at $35 per month, Emgality at $299 per pen and Trulicity at $389 per month ^[1][3].

Why it matters for patients

Medicare has been barred from covering drugs used for weight loss, and the Trump administration earlier this year dropped a Biden-era proposal to reinterpret that rule ^[1][4]. The new arrangement would use a Part D pilot to cover Wegovy and Zepbound for people with obesity and at least one related condition ^[1][3]. Coverage would not be universal: a senior administration official said about 10% of Medicare's roughly 66 million beneficiaries would be eligible, sorted into three groups — BMI above 27 with prediabetes or established cardiovascular disease; BMI above 30 with uncontrolled hypertension, kidney disease or heart failure; and BMI above 35 ^[4]. That is narrower than the FDA-approved population, which includes anyone with obesity or overweight plus one related condition ^[4].

Medicaid access is not automatic either. States must opt in to the $245 pricing, so some may not ^[4]. KFF counts 13 states currently covering GLP-1s for obesity ^[1].

Much remains unspecified. The administration has not released guidance to state Medicaid programs, the list of medications covered by each deal, the formula used to calculate MFN prices, or the reference countries ^[1]. A group of Senate Democrats and Sen. Bernie Sanders have asked HHS for implementation details, including how MFN prices interact with 340B and Medicare drug price negotiation ^[1]. Sources also differ on scope: the White House fact sheet describes new Medicare coverage of Wegovy and Zepbound for obesity ^[3], while AJMC, citing Novo Nordisk, describes a pilot covering Wegovy and Ozempic ^[2].

What happens next

TrumpRx.gov is scheduled to launch in January 2026 ^[1][4]. Medicare is expected to begin covering obesity drugs for some patients starting mid-2026 ^[4]. Separately, semaglutide is in the next round of Medicare drug price negotiations under the Inflation Reduction Act, with negotiated prices for 15 drugs expected by November 30 ^[4]. Tirzepatide likely will not be eligible for those negotiations until the end of the decade ^[4].