government\u2019s discount platform for buying prescription drugs with cash <\/a>\u2014 the average monthly cost for Wegovy and Zepbound will start at $350 and drop to $250 within the next two years, according to senior administration officials.<\/p>\nMedicare and Medicaid cover GLP-1 drugs for diabetes and some other medical conditions. These drugs include Novo Nordisk\u2019s Ozempic and Lilly\u2019s Zepbound.<\/p>\n
The drugmakers have voluntarily agreed to reduce the prices the government pays for all GLP-1 drugs already approved for diabetes and other indications to $245 a month across all non-starting doses. People on Medicare will pay no more than a $50 copay. People on Medicaid typically do not pay a copay.<\/p>\n
Both drugmakers will get relief from pharmaceutical tariffs for three years. <\/p>\n
The administration expects the direct-to-consumer pricing to be available by the end of the year on the TrumpRx site and Medicare coverage to be available by the middle of next year. <\/p>\n
The deal is part of Trump\u2019s \u201cmost favored nation\u201d push, an effort by the president to lower prescription drug prices and bring them more in line with other developed nations. Trump revived the initiative through an executive order in May after unsuccessfully pursuing it during his first term.<\/p>\n
Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said she has questions about how the plan would work next year, since Medicare has already set premiums and copays for 2026.<\/p>\n
She added that it\u2019s also unclear how many people would be able to access the drugs under the new deal. Medicare already covers Wegovy for patients with heart disease risk and Zepbound for sleep apnea, but not for weight loss alone. Ozempic is covered for diabetes. <\/p>\n
\u201cIt\u2019s not totally clear to me how expansive this is,\u201d she said, adding that $250 to $350 a month is still a lot of money for many people.<\/p>\n
\u201cThe good news is that people who want to use these medications and have the money can access them through direct-to-consumer avenues,\u201d she said.<\/p>\n
Juliette Cubanski, deputy director of the Medicare policy program at KFF, a nonpartisan health policy research, said she had questions about how the administration proposes to change Medicare coverage to include drugs for weight loss.<\/p>\n
\u201cWill this be a voluntary expansion or will plans be required to cover these drugs for people with obesity or overweight?,\u201d Cubanski said. \u201cHow does the administration propose to get around the current statutory prohibition against Medicare coverage of weight loss drugs?<\/p>\n
In a statement, Novo said Medicare coverage for weight loss drugs would be enabled through a pilot program, but did not provide further details.<\/p>\n
On an earlier call with reporters, senior administration officials said people on Medicare and Medicaid will be eligible for coverage if they are overweight or obese and meet certain criteria, such as having heart disease, kidney disease or severe obesity.<\/p>\n
Meanwhile, the deal mentioned that starting doses of GLP-1 pills will cost $149. No GLP-1 pills for weight loss have been approved, although Novo Nordisk and Lilly are studying these formulations. Lilly said it has applied for a \u201cpriority voucher,\u201d which would expedite the approval of a weight loss pill. A senior official said the administration expects that priority voucher will be approved Thursday. <\/p>\n
The administration has also reached similar pricing agreements with Pfizer and AstraZeneca to reduce costs for certain prescription drugs covered under Medicaid. <\/p>\n
The Biden administration previously proposed expanding Medicare and Medicaid coverage for GLP-1 drugs, but the Trump administration later rejected that plan. <\/p>\n
Ozempic and Wegovy are also among the drugs selected for the next round of Medicare price negotiations under the Inflation Reduction Act, which President Joe Biden signed into law in 2022. The Trump administration was expected to finalize new prices for 15 drugs \u2014 including the GLP-1s \u2014 by Nov. 1, but officials have shown less enthusiasm for the formal negotiation process, focusing instead on executive orders and voluntary pricing agreements with manufacturers. The administration is expected to unveil the new prices by Nov. 30.<\/p>\n
Trump\u2019s deal Thursday is not part of the Medicare drug pricing negotiations.<\/p>\n","protected":false},"excerpt":{"rendered":"President Donald Trump said Thursday his administration has reached a deal to lower the cost of the blockbuster…\n","protected":false},"author":2,"featured_media":115617,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[163,85,46,482],"class_list":{"0":"post-119287","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-health","9":"tag-il","10":"tag-israel","11":"tag-medication"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/119287","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=119287"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/119287\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/115617"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=119287"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=119287"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=119287"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}