Donald Trump was giddy. In the Oval Office today, the president announced that he had secured a deal to dramatically slash the price of obesity drugs. Soon, Wegovy and Zepbound will be sold on a new website—dubbed TrumpRx—for only about $250 a month, a fraction of their current retail price of more than $1,000. “Did I do a good job?” Trump asked the assembled reporters. “Do you think Biden could have done this? I don’t think so. ”
In some ways, the announcement heralds a breakthrough in expanding access to some of the nation’s most popular drugs. For years, millions of Americans have been priced out of these medications. Many private insurance plans do not cover these drugs, forcing people who want the weekly injections to pay out of pocket. The same situation has been playing out with Medicaid and Medicare. Only about a dozen states currently cover these obesity drugs for low-income Americans insured through Medicaid. And most seniors have been blocked from accessing the drugs, because Medicare is legally barred from covering weight-loss drugs.
Still, the announcement is more of a step forward than a leap. Both Novo Nordisk and Eli Lilly, the makers of Wegovy and Zepbound, respectively, already sell their drug directly to consumers for $499 a month. And most patients using TrumpRx won’t actually pay $250 for these drugs, at least initially. The price will be closer to $350 (exact costs will vary by dose), although the companies have promised to drop the price over the next two years, administration officials told reporters earlier today. (Novo Nordisk and Eli Lilly declined to comment for this story; the White House did not respond to my email.)
Patients are remarkably price sensitive when it comes to their medication—even when those drugs can mean the difference between life and death. A study from 2018 found, for example, that when out-of-pocket costs for cancer drugs were more than $100, a third of patients abandoned those prescriptions at the pharmacy counter. “Even at the lowest prices being offered by drug manufacturers, many people will struggle to pay out of pocket for these products,” Stacie Dusetzina, an expert on drug-pricing policy at Vanderbilt University, told me.
Under Trump’s deal, Medicare will now cover obesity drugs for the first time, allowing seniors to pay no more than $50 a month; the price for those insured by Medicaid will be even less. Even before today’s announcement, though, Medicare could cover the drugs for other conditions that often accompany being overweight, such as diabetes and sleep apnea. The Trump administration is opening up eligibility to those with prediabetes or certain heart conditions, among other comorbidities. Meanwhile, only seniors with severe obesity will be able to access these drugs through Medicare solely because of their weight. Overall, the Trump administration anticipates that roughly 10 percent of Medicare enrollees will be eligible to access these drugs following the announcement. It’s still unclear exactly what will happen with Medicaid. Coverage decisions ultimately rest not with the White House, but with the states.
What all of this means is that the biggest winners of today’s announcement might be the patients who are so desperate to access these drugs that they are willing to pay out of pocket. That’s only a small subset of patients. (A Novo Nordisk spokesperson told me before today’s announcement that roughly 10 percent of patients currently pay its discounted cash price for Wegovy.) How much someone with insurance pays for these drugs depends on their health plan; Eli Lilly notes on its website that through private insurance, people can pay as little as $25 a month.
Another factor is at play. Soon, patients may not be clamoring for Wegovy or Zepbound like they were before. America is about to enter a new era of GLP-1 drugs: Eli Lilly is expected to imminently submit an application to the FDA requesting approval to sell a new GLP-1 pill for weight loss. Novo Nordisk’s application for an oral pill is already pending before the FDA. As part of the deal with the government to cut prices, both companies were awarded vouchers that speed up the FDA’s review of their drugs. The announcement includes a commitment from both companies to sell the starting dose of new oral GLP-1 drugs for about $150; the higher doses for Eli Lilly’s drug will be capped at $399. (It’s still unclear how much Novo Nordisk will charge for higher doses of its oral drug.) Eli Lilly is similarly developing a new injectable GLP-1, retatrutide, that appears to be even more effective than the current drugs on the market—and which the company confirmed is not currently included in its agreement with the White House.
In his announcement, Trump gave himself credit for driving a hard bargain with drugmakers. “You think it was easy dealing with these people?” he said today. “It wasn’t.” But these companies are getting something in return. Both Eli Lilly and Novo Nordisk have made billions charging as much for these drugs as the market will allow. They’re on the cusp of brand-new drugs that are sure to be profitable.
