Trump's deal with Ozempic, Mounjaro makers to slash prices to $150: What's the catch?

On Thursday, November 6, 2025 the President and several top advisors announced a deal with Eli Lilly and Novo Nordisk to nominally decrease the prices of their GLP-1 products. The deal also lets Medicare cover those drugs for weight-loss purposes. Details on the nuts and bolts of the deal are scarce. But, as with any big policy move, industry impacts could be profound.

What’s the policy history surrounding GLP-1s?

Buckle up and brace for whiplash. Here’s a crash course in the topsy-turvy history of the government’s approach to these drugs.

The first GLP-1 was approved by the Food and Drug Administration in 2005 (Cleveland Clinic), but they didn’t really enter the public consciousness until recent years. Since approval, the drugs have been used in treating a wide variety of conditions – things like diabetes, obesity, sleep apnea, heart conditions, and well, a whole laundry list of others. That promise has led to both increasing demand and utility for the drugs, leaving both public and private insurers with a burning question: Will we cover GLP-1s, and how?

We’ll stay out of the weeds on private insurers (for now), but suffice to say that across all lines, if insurers are covering the drugs, it’s only to treat those with diabetes or other indicated chronic conditions. Few and far between are the plans that will cover them for weight-loss, as insurers argue that there isn’t enough long-term data to tell whether they provide meaningful improvement.

For public insurers (think Medicaid and Medicare), the Biden administration first proposed that Medicare and Medicaid could cover GLP-1s for weight loss purposes in its proposed rule for CY2026. That proposal was issued on November 26, 2024 – just before the second Trump term began.

In January 2025, the Trump administration had taken office. And in April, it released the final rule for CY2026. Inside, it refused to cover GLP-1s for weight-loss purposes, stating it would cost the government far too much money.

One more policy angle to consider: The Inflation Reduction Act of 2022 allowed CMS and Medicare to directly negotiate drug prices for the first time. CMS has selected GLP-1s, including Ozempic, Rybelsus, and Wegovy, for negotiation. The results of those negotiations are not yet public, but any negotiated price would go into effect in 2027.

What’s in the deal struck with Eli Lilly and Novo Nordisk?

The details are scarce, to be sure. What we know comes from high-level announcements. Here’s what those have said:

• Novo Nordisk’s Ozempic and Wegovy will see their prices drop to $350 if they are purchased through TrumpRx, the administration’s soon-to-be-launched direct-to-consumer prescription marketplace
• Eli Lilly’s Zepbound and Orforglipron (if approved) will decrease to $346 if purchased through TrumpRx
• If the FDA approves a Wegovy pill or other GLP-1s in pill form, they will be priced at $150 per month if purchased through TrumpRx
• Medicare and state Medicaid programs will be able to cover Ozempic, Wegovy, Mounjaro, and Zepbound at $245 per dose. On average, Medicare enrollees can expect a $50 copay. And, Medicare would now cover these drugs for weight-loss purposes.

What does this deal mean for consumers?

It’s probably best to explore this by market.

Medicare enrollees get the best deal here. At least, they will whenever the drug is added to formularies, and the rules and regulations are adjusted to allow for Medicare to cover weight-loss drugs. However long that takes is anyone’s guess. These prices were not arrived at via the Inflation Reduction Act negotiation process mentioned above, so there isn't much of a blueprint to go by.

But, assuming things go off without a hitch, at some point in 2026, Medicare enrollees can count this drug toward their Part D $2100 out-of-pocket max. After that, the remainder will be paid by their plan and the government.

Commercial enrollees – whether small or large – get a bit of a raw deal.

Group health plans (and the Pharmacy Benefit Managers who oversee formularies) were not participants in the negotiations. PBMs and large employers will need to negotiate their own rates for these drugs – should they choose to cover them for weight-loss purposes. And as we all know, lots of mouths get fed throughout the prescription drug market. So it’s unlikely, at least, in the short term, that customers using insurance will have access to these prices.

But what about customers who shop using TrumpRx when it becomes available?

While they’ll have access to the new lower prices, there’s an important caveat: Direct-to-consumer pharmaceutical sales rarely, if ever, count toward a consumer’s insurance accumulators.

Put another way, a consumer choosing to purchase these drugs directly via TrumpRx will pay, on average, $4,200 a year ($350 x 12 months). That’s $4,200 that won’t count toward deductibles or out-of-pocket maximums. Bluntly, that figure would challenge many consumers’ finances and leave them further exposed to the costs of other medical care.

Individual enrollees will find themselves in much the same boat as their commercial counterparts. There’s no guarantee the drugs will end up on their plans’ formularies, or at what price. Purchasing direct from TrumpRx would cause the same financial exposure that commercial enrollees would see, too.

What does this deal mean for the industry as a whole?

Certainly, the deal delivers on a promise to lower the cost of prescription drugs – for some Americans, at least. But it comes outside of the usual channels, and the inner workings are still very much unclear. Will other deals be made this way? If so, will lower drug prices in the Medicare market put downward pressure on prices in the commercial and individual markets—and will that finally put downward pressure on premiums? We’re not quite sure, but it will be interesting to watch.