What Trump’s New Drug Pricing Deal Means for People With Obesity

President Trump’s latest drug pricing deal, which would lower the costs of obesity medication, carries a flurry of new prices that will vary based on which product and dose you’re taking and how you’re paying.

Here’s what the news means for people who take or want to take obesity drugs:

Am I eligible to pay $149 a month?

The lowest price — $149 a month — applies only to the starting doses of two pills that are not yet on the market. One pill, orforglipron from Eli Lilly, is an entirely new drug; the other pill is a higher-dose, oral version of Novo Nordisk’s injectable drug Wegovy.

Eli Lilly said that the higher doses of orforglipron would cost no more than $399 a month. It is not clear yet what higher doses of Novo Nordisk’s pill will cost.

The drugs have been fast-tracked for review by the Food and Drug Administration, which is expected to approve the pills in the coming months.

What if I take Wegovy or Zepbound?

If you’re on Wegovy, the new direct-to-consumer price will be $350 a month, on average, depending on the dose. Novo Nordisk would not provide details on the planned price of each dose.

If you’re on Zepbound, the new consumer price will be $299 a month for the lowest dose and up to $449 for the higher ones.

Those prices are expected to become available within a few months.

How do the new prices compare to current ones?

Novo Nordisk currently offers all of its Wegovy doses at $499 a month for patients who use their own money. Eli Lilly has been offering its lowest dose for $349 and the others at $499.

Where can I find the new prices?

Patients will be able to access the new prices on direct-sales websites offered by Novo Nordisk and Eli Lilly.

The Trump administration plans to create a website, TrumpRx.gov, that will link to manufacturers’ websites like the ones offered by those companies. Officials put up a promotional version of the website last month and plan for it to be operational by the end of this year.

I’m on Medicare and have obesity. Will I be eligible for coverage?

It depends. People with a body mass index between 27 and 29 — who are overweight but not obese — and have prediabetes or established cardiovascular disease will now be eligible.

So are those with a body mass index in the low 30s — defined as mild obesity — who have conditions like uncontrolled hypertension, kidney disease or heart failure.

People with moderate or severe obesity, or a body mass index over 35, will also be eligible.

A small share of Medicare beneficiaries already had coverage for Wegovy or Zepbound because they have obesity in addition to a medical condition, like heart problems or sleep apnea.

But if you have a body mass index below 35 and do not have any of the relevant health conditions, you will not be eligible for coverage.

What will I pay if I’m on Medicare?

Eligible patients on Medicare will have a co-payment of no more than $50 a month. The coverage changes are expected to kick in around the middle of next year.

I’m on Medicaid and have obesity. Will I be eligible for coverage?

Medicaid already covers Wegovy and Zepbound for patients with certain health conditions, such as obesity with heart disease.

State Medicaid programs can decide whether to offer the medicines to patients for weight loss but are not required to do so. So far, a handful of states cover the drugs broadly for patients with obesity, though some have pulled back after facing budget pressure. The lower prices the federal government negotiated for the program could persuade more states to consider coverage.

Medicaid charges very low or zero co-payments for prescription drugs and for these drugs too when they are covered.

What if I have private insurance?

People on private insurance fall into two buckets: those whose plans cover the obesity drugs and those whose do not.

If your plan already covers the medication, you will likely be better off staying with that option, though you may want to compare your out-of-pocket costs. Many patients with coverage face co-payments of, say, $25 a month for Zepbound or Wegovy.

In this scenario, the deal may not change much for you in the short term or affect the price your plan negotiated with the manufacturer or the co-payment you are charged at the pharmacy. But the drug companies’ willingness to publicly endorse lower prices for other categories of patients may lead to lower prices and coverage for their workers.

If your plan doesn’t cover these drugs, and you can afford the direct-pay prices, the lower prices could help you. Some employer plans allow workers to count this kind of drug purchase toward their deductibles, so you could save a little money on other prescription drugs.

How do people take the obesity drugs?

Patients inject the drug once weekly. They typically start at a low dose and move up to higher doses over a matter of months under their doctors’ guidance.

Patients typically do not lose weight on the starter dose alone. They gradually increase doses over the course of months. Many people do not reach the highest doses, possibly because of cost issues or because they struggle with side effects.

The clinical trials that showed health benefits like reduced heart attacks were conducted studying the highest doses.

Dosing Levels for Weight-Loss Drugs

Wegovy, an injection for obesity, from Novo Nordisk: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, 2.4 mg

Ozempic, an injection for diabetes, from Novo Nordisk, 0.25 mg, 0.5 mg, 1 mg, 2 mg

Zepbound, an injection for obesity, from Eli Lilly: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg

Mounjaro, an injection for diabetes, from Eli Lilly, 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg