Trump deals with Lilly, Novo Nordisk could broaden obesity drug access

President Donald Trump on Thursday struck landmark deals with Eli Lilly and Novo Nordisk that would mark a turning point in how many individuals can access their costly blockbuster obesity drugs. 

Under the agreements, Medicare will start covering GLP-1s for obesity for certain patients for the primary time starting in mid-2026 – a shift that can open access to tens of millions of older adults and will spur more employers and other private insurers to follow suit, some experts said. Novo Nordisk and Eli Lilly are also lowering the costs that each one state Medicaid programs pays for GLP-1s, however it’s as much as states to opt into coverage. 

Obesity drug coverage amongst state Medicaid plans, employers and other private insurers stays spotty attributable to the $1,000 or more monthly list prices of existing GLP-1s, including Eli Lilly’s obesity injection Zepbound and Novo Nordisk’s competitor Wegovy. 

The limited insurance coverage has blocked out patients who cannot afford their hefty price tags. That lack of access has led to mounting pressure on health plans and the federal government to expand coverage — and the federal government agreements with drugmakers could mark a significant shift.

“I feel it’ll start with the federal government, start with Medicare, and the insurers will quickly follow,” Nick Fabrizio, an associate teaching professor in Cornell’s health policy program, told CNBC. “I do think that is coming.”

“That is an incredible step towards trying to handle a chronic and serious issue, and for those patients who may feel like they haven’t any hope,” he said.

Roughly 8 to 9 million people within the U.S. are using GLP-1s, Eli Lilly CEO David Ricks said at a briefing with reporters on Thursday. The added Medicare coverage under the deal could herald as many as 40 million latest eligible patients, and prompt more industrial plans to cover the medicines, he said.

The deals could also address the shortcoming of many patients with limited or no insurance coverage for obesity drugs to access them, by offering the treatments at a reduction on the Trump administration’s direct-to-consumer website, TrumpRx.gov. 

The monthly out-of-pocket cost of existing injections and upcoming pills could range from $50 to $350 starting next yr, depending on the dosage and insurance coverage a patient has. 

Still, there may be a law prohibiting Medicare from covering weight reduction drugs, so any changes would have to return from Congress. Eli Lilly’s Ricks told reporters Thursday that for now, the federal government will launch an initial pilot program within the spring of 2026 under a short lived legal mechanism. It might be voluntary for Medicare prescription drug plans, so “it could be possible that a number of plans don’t participate, but I might expect just about all do,” he said. 

But Ricks said that it is going to transition right into a formal so-called Center for Medicare and Medicaid Innovation pilot program in 2027, which suggests it is going to be mandatory for all Medicare Part D plans.

“So we expect broad coverage in all plans each in 2026 and beyond,” he said.

Coverage for GLP-1s for obesity has ticked up barely, but stays sparse: A May survey of greater than 300 corporations by the International Foundation of Worker Profit Plans found that 36% provided coverage for GLP-1s for each weight reduction and diabetes, up from 34% in 2024. 

Around a dozen state Medicaid programs cover obesity drugs, in response to 2024 estimates from KFF, a health policy research organization. While GLP-1s offer substantial health advantages to Medicaid beneficiaries, state programs are already facing constrained budgets and administrative demands.

Fabrizio added that raising taxes to cover the drugs “might be a sticky issue.”

Still, JPMorgan’s Schott said offering lower prices to Medicaid programs may lead to a “significant increase in coverage” in that channel, where Zepbound has very limited uptake.