Overview
- Cash purchases through the forthcoming TrumpRx platform are slated to start around $350 per month for injectables and could fall toward $250 over two years, with starting-dose pills proposed at about $149 pending FDA approval.
- Medicare and Medicaid net prices are set near $245 per month, and qualifying Medicare beneficiaries would see a roughly $50 monthly copay under a pilot beginning in mid-2026 that is expected to transition to a broader CMMI demonstration in 2027.
- Medicare access will be limited to patients meeting clinical criteria such as specific BMI thresholds paired with conditions like prediabetes or established cardiovascular disease, leaving coverage for weight loss alone unchanged under current law.
- Out-of-pocket purchases may not count toward insurance maximums, dosing prices for injections can rise at higher strengths, commercial insurer coverage remains uncertain, and Medicaid expansion will depend on state opt-ins.
- The agreements include three years of tariff relief for the manufacturers, shares of Novo Nordisk and Eli Lilly fell after the announcements, and Novo Nordisk guided to a direct low single-digit hit to 2026 global sales growth as volumes potentially expand.