(CNN) \u2014 Janet McCaskill was on vacation in Arizona with her husband and best friend when she heard that President Donald Trump had suggested he might be able to bring the cost of popular weight-loss drugs down to $150 a month.<\/p>\n
\u201cThe thought of it going to $150 a month is dramatic,\u201d said McCaskill, a grandmother from North Carolina who\u2019s lost 100 pounds<\/a> with the help of GLP-1 medicines, a class best known for the diabetes drug Ozempic. \u201cThat is most fantastic \u2013 if it comes to pass.\u201d<\/p>\n Trump planted the idea Thursday in an Oval Office news conference about an entirely different set of drugs \u2013 those for in vitro fertilization<\/a> \u2013 before his Centers for Medicare and Medicaid Administrator, Dr. Mehmet Oz, stepped in to warn it wasn\u2019t a done deal.<\/p>\n Nonetheless, Trump\u2019s comments made waves. Patients who\u2019ve struggled to afford the pricey medicines shared hope the price could be reached. Doctors called it \u201chuge for patients,\u201d if true. And in a sign that Wall Street took it seriously, stocks of Novo Nordisk and Eli Lilly, the makers of GLP-1 drugs Ozempic, Wegovy, Mounjaro and Zepbound, fell significantly, wiping out tens of billions of dollars in the companies\u2019 market values.<\/p>\n It\u2019s just not clear it\u2019ll actually happen.<\/p>\n An awkward moment in the Oval<\/p>\n It started with a familiar refrain from the president, who\u2019s previously lamented<\/a> the cost difference of weight-loss drugs in Europe compared with the US.<\/p>\n \u201cIn London, you\u2019d buy a certain drug for $130 \u2026 and in New York, you pay $1,300 for the same thing,\u201d Trump said in opening remarks of his IVF announcement Thursday. \u201cSo now we\u2019re going to be paying, instead of $1,300, you\u2019ll be paying about $150.\u201d<\/p>\n A reporter, Max Bayer of Endpoints News, made the connection, asking later if Trump was referring to bringing weight-loss drugs down to $150. The president confirmed he was \u201creferring to Ozempic, or the fat-loss drug \u2026 they\u2019ll be much lower.\u201d<\/p>\n At that point, Dr. Oz started to look uncomfortable, stepping up to the podium with a subtle shaking of his head.<\/p>\n \u201cWe have not negotiated those yet,\u201d Oz clarified. \u201cWe\u2019re going to be rolling these out over time.\u201d<\/p>\n It didn\u2019t take long for Novo Nordisk and Eli Lilly\u2019s stocks to react, each dropping about 4% in after hours trading Thursday and maintaining losses through trading on Friday. A Wall Street analyst, Evan Seigerman of BMO Capital Markets, sought to assuage investor fears of coming price cuts in a research note Thursday evening that called Trump\u2019s remarks \u201caggressive posturing amidst negotiations.\u201d<\/p>\n The drug companies were tight-lipped. Novo Nordisk, which makes Ozempic and its weight-loss counterpart, Wegovy, told CNN that the company \u201chas engaged in discussions\u201d with the Trump administration about drug pricing in the context of the president\u2019s Most Favored Nation executive order, an approach that dictates the US shouldn\u2019t pay more for medicines than the lowest price offered to peer nations.<\/p>\n Medicines are routinely sold at markedly higher prices in the US than other countries, including diabetes and weight-loss drugs: Ozempic is priced 10 times higher in the US than France, according to a 2023 analysis<\/a> from Peterson-KFF.<\/p>\n \u201cWe remain focused on improving patient access and affordability, and we will continue to work to find solutions that help people access the medication they need,\u201d a Novo Nordisk spokeswoman said.<\/p>\n A spokesman for Eli Lilly, which makes Mounjaro for diabetes and Zepbound for weight loss, said the company is \u201cnot aware of any specific price commitments,\u201d and that it\u2019s \u201cin discussions with the administration to further expand patient access, preserve innovation and promote affordability for our medicines.\u201d<\/p>\n \u2018Most Favored Nation\u2019 drug prices<\/p>\n The president has announced deals with Pfizer<\/a>, AstraZeneca<\/a> and EMD Serono<\/a> in the past month under the Most Favored Nation framework, and has promised more to come. The deals so far have included an offering of medicines at Most Favored Nation prices to Medicaid \u2013 a system that already receives heavy discounts \u2013 as well as deals on certain drugs that can be purchased directly by consumers, without insurance, through a new platform called TrumpRx.<\/p>\n In return, drugmakers have won reprieves from the threat of tariffs, as long as they continue to invest in manufacturing and research in the US.<\/p>\n Thus far, the deals have appeared neutral or positive to pharmaceutical companies, with Pfizer\u2019s stock rising<\/a> the day of its announcement and buoying competitors along with it. The agreements, Seigerman wrote, \u201chave been far from a sweeping implementation of US pricing cuts.\u201d<\/p>\n The drugs Pfizer and the White House noted would be offered<\/a> through the TrumpRx program don\u2019t appear to be used very often in the US, face generic competition in the near future, or carry such high list prices that even steep discounts for cash-paying patients would leave the medicines unaffordable for most people, said Stacie Dusetzina, a professor of health policy at Vanderbilt University Medical Center.<\/p>\n GLP-1 medications, though, so-called for a hormone they mimic, are used by millions of Americans, and \u201cif you look at the barriers to using them, cost is the number one thing,\u201d said Dr. Louis Aronne<\/a>, director of the Comprehensive Weight Control Center at Weill Cornell Medicine.<\/p>\n From thousands to hundreds<\/p>\n The medicines are all priced, before insurance or discounts, at about $1,000 a month or more in the US. With commercial insurance coverage, many patients pay as little as $25 out of pocket. But coverage can be thorny, especially for weight loss, and some insurers are reducing coverage<\/a>.<\/p>\n McCaskill experienced that firsthand. She started using Mounjaro in late 2022 to try to lose weight, and had such strong results, she credits the medicine with saving her life. But her insurance didn\u2019t cover it, and it was so expensive she switched to a compounded version made by a local pharmacy.<\/p>\n Compounders typically make drugs that require personalization, like if a patient is allergic to a certain ingredient or needs other modifications made. But law also allows compounding when medicines are in shortage, and GLP-1 manufacturers had trouble meeting outsized demand for several years, opening up an entire market of off-brand, compounded GLP-1s.<\/p>\n Though the shortages have now ended<\/a>, some purveyors still offer compounded versions of the medicines, at much lower prices than Novo Nordisk and Eli Lilly \u2013 even after the companies introduced<\/a> cash pay discounted options.<\/p>\n