Can Trump do for brand-name expensive drugs what he just did for GLP-1?

When the Trump administration announced earlier this year that it would not finalize provisions proposed by the Biden administration to expand GLP-1 Medicare and Medicaid coverage, many supporters were deeply disappointed.

But this month, the Trump administration announced deals with GLP-1 makers Eli Lilly and Novo Nordisk to expand access to the popular weight-loss drug. The agreement will allow patients to obtain GLP-1 at a significantly cheaper price through TrumpRx, a government-run direct-to-consumer drug platform. It also lowers Medicare and Medicaid prices and enables Medicare to cover GLP-1, which treats obesity, for the first time.

In addition to the deal with the Trump administration, Eli Lilly has charted a new course to expand access to GLP-1. The company on Friday announced plans to build an employer-focused obesity management medication model that includes flexible benefit design options for obesity management care, a dedicated pharmacy network and third-party obesity management programs. This feature will be launched in 2026.

While many applaud the Trump administration for taking this step to expand the use of GLP-1, some believe that specifically targeting the weight-loss drug will actually do little to reduce overall prescription drug costs.

“I think focusing solely on market solutions for GLP-1 misses the mark because this is a market problem,” said Chris Deacon, principal and founder of VerSan Consulting. “[Whether it’s] With GLP-1 or other drugs, the problem we have is a complete lack of transparency for buyers. “

Another expert echoed these comments, noting that while this is a positive move, a broader effort will be needed to effectively fully reduce drug costs.

“This is a step in the right direction,” said Edgar Asebey, an FDA regulatory attorney at Frier Levitt. “A policy initiative that was more like a blanket policy for brand-name drugs would be much better for American patients.”

What is the Trump administration's deal?

According to a fact sheet, the Trump administration's deal with Novo Nordisk and Eli Lilly and Company had several elements, including:

• Consumers can access Ozempic and Wegovy for $350 when purchased through TrumpRx, with list prices exceeding $1,000
• Allows consumers to use Zepbound and Orforglipron (if approved) for $346 through TrumpRx, with list prices exceeding $1,000
• If the FDA approves the Wegovy pill, initial doses will be available through TrumpRx for $150 per month
• The Medicare price for Ozempic, Wegovy, Mounjaro and Zepbound will be $245, and for the first time Medicare will allow coverage for obesity in Wegovy and Zepbound. Medicare beneficiaries will pay a $50 monthly deductible
• State Medicaid programs will also have authority to use these prices under GLP-1. States can currently decide whether to include obesity drugs in Medicaid, and 13 states have already done so, according to KFF
• Other drugs from Eli Lilly and Novo Nordisk will also cost less through TrumpRx, including migraine treatment Emgality, diabetes drug Trulicity and insulin products NovoLog and Tresiba

What do the experts say?

VerSan Consulting's Deacon noted that while the Trump administration's agreement lowered GLP-1 prices in the United States, those prices are still significantly higher than in other countries. For example, Ozempic costs $96 in Sweden, $93 in the UK, $87 in Australia and $83 in France, according to KFF.

To truly reduce prescription drug costs, the focus should not be solely on GLP-1, she added.

“I think continuing to focus on GLP-1 is a very smart tactical move by the industry because that's what people want,” she said. “It feels like we're buying off the American people and feeding their need for reform in the pharmaceutical sector by focusing on GLP-1, because that's what everyone is talking about and what a lot of people want. … At the same time, what really needs to be reformed is the entire chain of drug procurement.”

Frier Levitt's Asebey agrees, noting that one of the main reasons GLP-1 prices have dropped significantly in other countries is the single-payer system. While he thinks this is a great first step, there are many other high-cost drugs that need to be reduced, such as cancer drugs.

“It's not as beneficial as if we had a single-payer system because we don't know … whether that's going to impact employer health plans,” he said. “Yes, private benefit administrators are negotiating on these things, but that's separate from what the White House is doing now. It's still a question mark. These are not the only drugs. These are the most popular drugs, but other critical drugs are still very expensive. What's going to happen to them?”

The United States is far from transitioning to a single-payer system. In the absence of a single payer system, Assibe hopes the government will continue to take similar action to lower drug costs, even if it is more “piecemeal.”

He also made this suggestion:

“I think it would be great if the Trump administration announced that every year they would introduce the top 40 brand-name drugs and add them to the formulary and they would negotiate drug pricing. They've already done that with Novo Nordisk and Eli Lilly. Obviously, none of these companies are going to go out of business, and they have the ability to continue to enter the U.S. market at very profitable prices. But I think President Trump should use this forum to benefit more Americans, not just those who want to lose weight or have diabetes.”

It's worth noting that there have been other attempts to control drug costs. For example, efforts are underway to advance the 340B drug pricing program, although some believe this will not solve the program's problems. Congress has also pursued PBM reforms, although these efforts have not yet materialized.

There are also steps being taken to support employer-sponsored programs, such as Eli Lilly's announcement Friday of an employer-focused model for weight management medications. Digital health companies Waltz Health and 9amHealth also announced employer models on Friday to expand access to Eli Lilly and Co.'s obesity management drug. However, these programs still specifically target weight loss drugs rather than addressing drug costs holistically.

At the same time, a Prescription drug advocates say Trump's GLP-1 deal is “life-changing” for those who rely on the drugs but question the drug companies' motives.

“Voluntary deals depend on the 'goodwill' of companies, which have a long history of using their power to maintain high prices at the expense of patients,” said Merith Basey, executive director of Affordable Medicines for Patients. “Eli Lilly and Novo Nordisk have been raising insulin prices in concert for years, so there are real concerns that GLP-1 prices could rise just as quickly as they did after the price cuts. The manufacturers alone set launch prices, which is a stark reminder of why we urgently need reforms to control prices.”

Like Deacon and Asebey, Basey believes efforts beyond GLP-1 are needed to make a real difference. She believes that Medicare negotiations are currently the most effective tool in reducing drug costs in the United States and that the program should be expanded.

“Lower prices for GLP-1s will help many people, and we're pleased to see this progress. But fixing the prescription drug market, not just one class of drugs, will require structural changes to ensure all patients have access to the prescription drugs they need at a price they can afford,” she said.

Photo: Jason Dean, Getty Images