Likely the most notable feature of the deals is Medicare coverage of obesity drugs, as it will allow the treatments to reach new patients in the program and could lead to broader private insurance coverage. 

Under the deals, Eli Lilly and Novo Nordisk agreed to cut the price Medicare and Medicaid pay for GLP-1s to $245 per month. In Medicare specifically, certain patients will pay a copay of $50 per month for all approved uses of injectable and oral GLP-1 drugs, including diabetes and obesity treatment.

But the Trump administration is putting some constraints on which Medicare beneficiaries will be eligible to receive GLP-1s for obesity and cardiovascular and metabolic benefits. People who qualify include patients with a body mass index of 27 or above with prediabetes or established cardiovascular disease; people with a BMI of 30 or more with related health conditions; or those with severe obesity, or a BMI of 35 and above. 

GLP-1s for weight loss are approved for a broader population: people who have obesity or are overweight with one related condition. In a note Thursday, Leerink Partners analyst David Risinger also said it’s unclear whether the government will allow patients to stay on a GLP-1 for obesity after their BMI levels drop. 

Even with those restrictions, “I think in practice, it’s still going to cover a fair number of people,” said Darius Lakdawalla, chief scientific officer at the University of Southern California’s Schaeffer Center.

JPMorgan analyst Chris Schott said the eligibility criteria mean 80% of the obese population in Medicare could receive coverage for GLP-1s, despite the limits.

“Today’s deal will open up meaningful access to obesity drugs,” Schott said in a note about Eli Lilly on Thursday. 

Lakdawalla added that while there isn’t clear evidence that private insurers will expand coverage on the heels of government plans, “it’s just optically harder for them to continue to constrain coverage when Medicare and Medicaid are covering them.” 

“That’s going to exert some pressure for commercial coverage of these drugs to expand as well,” Lakdawalla said. 

Lakdawalla said the direct-to-consumer offerings under the deal could be useful for people who are underinsured, uninsured or may not have coverage for obesity medicines. Still, it’s unclear how many more patients the drugs will reach due to the offerings. 

Both Eli Lilly and Novo Nordisk have introduced lower cost options for their drugs for people paying in cash and purchasing the drugs directly through their websites. But the deals with Trump will give those patients even bigger discounts.

On TrumpRx, the average monthly cost for Wegovy, Zepbound and other injectable GLP-1s will start at $350 and drop to $250 within the next two years, according to senior Trump administration officials. Eli Lilly and Novo Nordisk both offered some GLP-1s on their direct-to-consumer platforms for up to $450 to $500 per month.

Starting doses of obesity pills from Eli Lilly and Novo Nordisk — expected to hit the market next year — will be $149 per month on TrumpRx, Medicare and Medicaid.  

Eli Lilly on Thursday said it would lower prices by $50 on its own direct-to-consumer platform, LillyDirect, which already offers Zepbound and other drugs at a discount to cash-paying patients. The multidose pen of Zepbound will be available for $299 per month at the lowest dose, with additional doses being priced up to $449 per month.

In terms of Medicaid, Cornell’s Fabrizio said states will likely want to start covering obesity drugs at the lower price point, “but the question is how will they pay for it?”