Overview
- Eli Lilly and Novo Nordisk agreed to sell injectable GLP-1 drugs to Medicare and Medicaid at about $245 per month, with Medicare beneficiaries paying a $50 monthly copay and Medicaid patients facing minimal out-of-pocket costs.
- TrumpRx, a direct-sale pathway the administration plans to launch in January 2026, is slated to offer Wegovy and Zepbound around $350 per month at launch with a potential glide path toward roughly $250, though eligibility and operations are still being set.
- If FDA clears oral GLP-1 pills, both companies pledged lowest-dose prices near $149 per month, and FDA has already granted priority voucher reviews to oral semaglutide and orforglipron with decisions targeted within roughly two months.
- CMS intends to expand Medicare and Medicaid access to certain high-risk patients with obesity, with the administration estimating about 10% of beneficiaries could qualify and aiming for new Medicare coverage by mid‑2026, while private insurance implications remain unresolved.
- Authorities report large seizures of counterfeit GLP-1 products and the FDA has recorded hundreds of hospitalizations and more than 20 deaths linked to fake or illegally compounded doses, underscoring ongoing safety and enforcement concerns.