US advances MFN pricing deals for obesity drugs with Eli Lilly and Novo Nordisk

The Trump administration has unveiled new most-favored-nation (MFN) pricing agreements with Eli Lilly and Novo Nordisk to expand access to obesity and diabetes medicines while boosting US pharmaceutical manufacturing. The arrangements, announced jointly by the White House and both companies, introduce lower prices for GLP-1 receptor agonists through the new TrumpRx purchasing platform.

According to the White House fact sheet, under the agreements, Novo Nordisk’s Ozempic and Wegovy will see monthly prices fall from around US$1000 and US$1350 to US$350 when purchased through TrumpRx, the new federal initiative recently introduced by the Trump administration to lower the cost of prescription drugs in the US. Lilly’s Zepbound and investigational oral therapy orforglipron, if approved, will be priced at about US$346 per month. Should oral versions of GLP-1 drugs such as the Wegovy tablet receive US FDA authorization, introductory doses will start at US$150 per month.

Novo Nordisk confirmed that the agreement includes price reductions across Medicare Part D, Medicaid, and direct-to-patient programs beginning in 2026, alongside a three-year tariff exemption. “Today’s announcement will bring semaglutide medicines to more American patients at a lower cost,” said Mike Doustdar, President and CEO of Novo Nordisk.

In their announcement, Lilly described the agreement as a landmark step toward improving how Americans access and pay for innovative therapies. Chair and CEO David A Ricks said the company is working with the US government to “rebalance the global system, expand access, and lower costs” while maintaining investment in innovation and manufacturing. He called the deal “a pivotal moment in US health policy,” extending Lilly’s affordability initiatives, including its US$35 insulin cap and LillyDirect platform, to expand access to obesity medicines for millions of Americans.

Through the deal, Medicare will pay US$245 per month for GLP-1 products such as Ozempic, Wegovy, Mounjaro, and Zepbound, while patients will have a US$50 co-pay. State Medicaid programs will access the same MFN pricing, extending coverage for obesity treatments to adults with related comorbidities for the first time. The companies also committed to providing discounted prices for other products, including insulin and migraine therapies, and to maintaining MFN pricing on future launches.

The timing of the announcement comes as semaglutide (the active ingredient in Ozempic and Wegovy) is under review as part of the second cycle of the Medicare Drug Price Negotiation Program (DPNP), covering drugs with the highest expenditure under Part D. The Centers for Medicare & Medicaid Services (CMS) is expected to announce the agreed-upon maximum fair prices (MFPs) by the end of November 2025. The negotiated prices will apply from 2027, following the completion of statutory negotiation and implementation processes.

Both companies have also pledged substantial new investments to expand their domestic manufacturing footprint, US$27 billion from Eli Lilly and US$10 billion from Novo Nordisk, including end-to-end production of the Wegovy tablet, if approved.

The announcement adds another layer to the evolving US drug-pricing landscape. The sheer complexity of the matrix has been described as “dizzying” by Brian Reid on LinkedIn (in a thread worth reading). As the field heads to ISPOR Europe next week, its ripple effects on global pricing, access, and evidence-generation strategies will no doubt enter the conversation, even amid the event’s EU-focused agenda.