President Trump announced new deals to lower the price of popular weight loss medications Wegovy and Ozempic, sparking both optimism and confusion. While these agreements aim to make these drugs more affordable through initiatives like TrumpRx, a direct-to-consumer online platform, and reduced prices for Medicare and Medicaid recipients, several unanswered questions remain about their true impact.
Starting in January 2026, patients will be able to buy Wegovy (semaglutide) and Zepbound (tirzepatide), both blockbuster weight loss drugs produced by Novo Nordisk and Eli Lilly respectively, directly through TrumpRx at an average monthly price of $345. This is projected to drop to $250 per month by 2028. The platform will direct patients to drugmaker-run online stores where further discounts may be available for uninsured or underinsured individuals.
However, the administration’s claim that these prices represent a “most-favored nation” (MFN) rate – meaning they are lower than those in comparable wealthy nations – appears misleading. While there is some variation in out-of-pocket costs among European patients, studies show significantly cheaper prices for these drugs exist elsewhere.
Despite being touted as lower than current U.S. direct-to-consumer market prices (around $499 per month), the $345 figure may have limited impact on most insured individuals who already pay co-payments of less than $100 per month for maintenance doses.
Medicare and Medicaid: A Murky Picture
The agreements also stipulate that the drugs will be sold to Medicare and Medicaid for $245 per month, with a $50 co-pay for Medicare beneficiaries. This price raises further questions:
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Conflicting timelines: Does this $245 figure coincide with the maximum fair price negotiated under the Inflation Reduction Act (IRA) for semaglutide products (like Ozempic, Rybelsus, and Wegovy), set to take effect in January 2027? The White House insists that the $245 deal will apply from mid-2026, preempting the IRA pricing.
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Separate negotiations?: If the IRA-negotiated price is indeed separate (and potentially higher than $245), what role does this new agreement play? Could it operate through a Medicare pilot program announced by the administration three months ago, which makes participation voluntary for insurance plans and has a temporary duration?
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Coverage expansion: While the agreements promise expanded coverage under Medicare and Medicaid for obese patients with certain metabolic or cardiovascular risks (defined by specific BMI thresholds and conditions), it’s unclear if this constitutes substantial progress. Many individuals within these categories already qualify for current coverage based on pre-existing FDA indications. For others without co-morbidities, existing coverage remains unchanged.
Beyond Price: Incentives for Pharma Giants
Novo Nordisk has confirmed a separate maximum fair price agreement with Medicare under the IRA but hasn’t disclosed the exact figure. They have, however, indicated it will minimally impact sales, suggesting it might be higher than $245.
Eli Lilly and Novo Nordisk gain more than just potential market expansion through these deals. They receive tariff reprieves on pharmaceuticals and priority review vouchers – accelerating the approval process for new drug candidates.
Unanswered Questions Remain
While Trump’s administration aims to achieve lower drug prices, the details surrounding these agreements raise more questions than they answer: What is the true impact on patient access? How will these deals affect existing Medicare coverage models and future IRA price negotiations? And what are the long-term implications for pharmaceutical pricing strategies in the face of government intervention?
Clearer explanations from both the administration and the pharmaceutical companies are crucial to assess the true effectiveness of these ambitious efforts. Only time will tell if they represent a meaningful step towards greater affordability or simply another layer of complexity within an already opaque system
