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Millions more Americans could access obesity drugs after Trump’s deals with Eli Lilly, Novo Nordisk
US President Donald Trump makes an announcement in the Oval Office of the White House in Washington, DC on Nov. 6, 2025.
Andrew Caballero-Reynolds | AFP | Getty Images
President Donald Trump on Thursday struck landmark deals with Eli Lilly and Novo Nordisk that could mark a turning point in how many people can access their costly blockbuster obesity drugs.
Under the agreements, Medicare will start covering GLP-1s for obesity for certain patients for the first time beginning in mid-2026 – a shift that will open access to millions of older adults and could spur more employers and other private insurers to follow suit, some experts said. Novo Nordisk and Eli Lilly are also lowering the prices that all state Medicaid programs will pay for GLP-1s, but it’s up to states to opt into coverage.
Obesity drug coverage among state Medicaid plans, employers and other private insurers remains spotty due to the $1,000 or more monthly list prices of existing GLP-1s, including Eli Lilly’s obesity injection Zepbound and Novo Nordisk’s competitor Wegovy.
The limited insurance coverage has blocked out patients who can’t afford their hefty price tags. That lack of access has led to mounting pressure on health plans and the government to expand coverage — and the government agreements with drugmakers could mark a major shift.
“I think it’ll start with the government, start with Medicare, and the insurers will quickly follow,” Nick Fabrizio, an associate teaching professor in Cornell’s health policy program, told CNBC. “I do think that’s coming.”
“This is a great step towards trying to address a chronic and serious issue, and for those patients who may feel like they have no hope,” he said.
Roughly 8 to 9 million people in the U.S. are using GLP-1s, Eli Lilly CEO David Ricks said at a briefing with reporters on Thursday. The added Medicare coverage under the deal could bring in as many as 40 million new eligible patients, and prompt more commercial plans to cover the medicines, he said.
The deals could also address the inability of many patients with limited or no insurance coverage for obesity drugs to access them, by offering the treatments at a discount on the Trump administration’s direct-to-consumer website, TrumpRx.gov.
The monthly out-of-pocket cost of existing injections and upcoming pills could range from $50 to $350 starting next year, depending on the dosage and insurance coverage a patient has.
Still, there is a law prohibiting Medicare from covering weight loss drugs, so any changes would have to come from Congress. Eli Lilly’s Ricks told reporters Thursday that for now, the government will launch an initial pilot program in the spring of 2026 under a temporary legal mechanism. It would be voluntary for Medicare prescription drug plans, so “it may be possible that a few plans do not participate, but I would expect almost all do,” he said.
But Ricks said that it will transition into a formal so-called Center for Medicare and Medicaid Innovation pilot program in 2027, which means it will be mandatory for all Medicare Part D plans.
“So we expect broad coverage in all plans both in 2026 and beyond,” he said.
Medicare coverage could be a sea change
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.
Coverage for GLP-1s for obesity has ticked up slightly, but remains sparse: A May survey of more than 300 companies by the International Foundation of Employee Benefit Plans found that 36% provided coverage for GLP-1s for both weight loss and diabetes, up from 34% in 2024.
Medicaid, direct-to-consumer offerings could fill gaps
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?”
Around a dozen state Medicaid programs cover obesity drugs, according to 2024 estimates from KFF, a health policy research organization. While GLP-1s offer substantial health benefits to Medicaid beneficiaries, state programs are already facing constrained budgets and administrative demands.
Fabrizio added that raising taxes to cover the drugs “could be a sticky issue.”
Still, JPMorgan’s Schott said offering lower prices to Medicaid programs could lead to a “significant increase in coverage” in that channel, where Zepbound has very limited uptake.
Scotland’s Finance Secretary says she may have to “potentially revisit” her tax plans amid reports the Chancellor will increase income tax in the Budget this month.
Shona Robison said the Scottish Government had a “very limited” set of levers to respond if Rachel Reeves makes the tax decision on November 26.
The Fraser of Allander Institute has estimated a 2p income tax hike in the UK Budget could cut Scotland’s funding by £1 billion because of the way the fiscal framework operates.
Ms Robison has requested an urgent meeting with the Chancellor, saying Ms Reeves should ditch her fiscal rules and instead deliver investment “to grow the economy and support people with the cost of living”.
Speaking to BBC Scotland’s Sunday Show, Ms Robison said the fiscal framework does not take account of changes to national insurance – another levy the Chancellor is reportedly considering changing.
The fiscal framework governs the public money coming to the Scottish Government, but Ms Robison said the system is now in “uncharted territory” as it did not envisage simultaneous changes to both income tax and national insurance.
Ms Robison was asked if she would raise Scottish income tax rates in response to any income tax increase in the Chancellor’s Budget.
She said: “I’m not going to set out here today what our plans for income tax are when we don’t know what we’re going to face on the 26th…
“If we end up in this scenario, then the levers available to us are very limited.
“Unless there is flexibility given to us through the fiscal framework – which would be my first ask, that we need to have that flexibility.
“Because we don’t want to raise taxes, we had already set out in the tax strategy that we want to see that stability till the end of the Parliament.
“But in the event of unforeseen exceptional circumstances, clearly we would have to potentially revisit that.”
Under the devolution settlement, the Scottish Government has powers to adjust income tax rates north of the border.
An HM Treasury spokesperson said earlier: “Our record funding settlement for Scotland will mean over 20% more funding per head than the rest of the UK.
“We have also confirmed £8.3 billion in funding for GB Energy-Nuclear and GB Energy in Aberdeen, up to £750 million for a new supercomputer at Edinburgh University, and are investing £452 million over four years for City and Growth Deals across Scotland.
“This investment is all possible because our fiscal rules are non-negotiable, they are the basis of the stability which underpins growth.”
Business
Pakistan’s manufacturing sector slump: Private investment plunges 46%; experts warn of long-term industrial decay – The Times of India
Pakistan’s manufacturing industry, once considered a key driver of economic growth and employment, is undergoing one of its worst downturns in recent history. The sector has seen a steep 46 per cent fall in private investment over the past six years, raising fears of long-term stagnation among economists and industrial experts.According to The Express Tribune report cited by news agency ANI, private investment in manufacturing dropped from PKR 706 billion in FY2018–19 to just PKR 377 billion in FY2024–25, marking the weakest phase of industrial growth in more than a decade. Ali Imran Asif, Senior Executive Committee Member of the Lahore Chamber of Commerce and Industry (LCCI), warned that the current level of investment was “not enough to even replace depreciating machinery,” suggesting a deep erosion of Pakistan’s industrial foundation.“We are not dealing with a short-term dip; we are watching our industrial base disintegrate,” Asif said, as per The Express Tribune. He stressed that without structural reforms focused on productivity, innovation, and competitiveness, the country could face prolonged industrial paralysis.The combined contribution of the manufacturing and mining sectors to Pakistan’s GDP has remained stagnant at around 13.2 per cent over the past six years. Frequent policy changes, high energy costs, and volatile currency movements have severely affected export-oriented sectors such as textiles, leather, and engineering goods. Large-scale manufacturing output fell 1.5 per cent in FY25, reversing the 0.92 per cent growth recorded in FY24.In contrast, neighbouring economies like India and Bangladesh have maintained strong industrial growth supported by stable policies and export diversification. Economist Shahid Saleem noted that Pakistan’s slump is not merely the result of high interest rates but also reflects policy inconsistency and eroding investor confidence. Import restrictions and weak domestic demand have forced many factories to run below capacity, he added.Experts, as cited by ANI, warned that unless Pakistan swiftly formulates a credible industrial revival plan and ensures policy stability, the manufacturing sector’s decline will deepen further, undermining exports, employment and broader economic resilience.
Getty ImagesMore than 1,400 flights to, from, or within the US were cancelled on Saturday after airlines were told this week to cut traffic during the federal government shutdown.
Nearly 6,000 flights were also delayed, down from over 7,000 delays on Friday, according to flight tracker FlightAware.
The Federal Aviation Administration (FAA) announced earlier in the week that it would be reducing air travel capacity by up to10% at 40 of the nation’s busiest airports as air traffic controllers, who are working without pay during the shutdown, report fatigue.
Republicans and Democrats remain divided over how to end the impasse in Congress as the shutdown, which began 1 October, continues.
Saturday marked the 39th day of the longest shutdown in history as Republicans and Democrats still have not agreed on a funding resolution to reopen the government.
Senators are in Washington over the weekend for bipartisan negotitations aimed at ending the shutdown, which is beginning to be felt by more and more Americans amid cuts to food aid payments and the flight disruptions.
In a statement on Saturday, American Airlines urged “leaders in Washington, D.C., to reach an immediate resolution to end the shutdown”.
New Jersey’s Newark Liberty International Airport was experiencing some of the longest wait times. As of Saturday afternoon, arrivals to the airport were delayed by an average of more than four hours, while departures from the airport were delayed by an average of 1.5 hours, according to the FAA.
The airports with the most cancelled flights on Saturday, both to and from the location, were Charlotte/Douglas International, Newark Liberty International, and Chicago O’Hare International, according to FlightAware.
Departures to John F Kennedy International, Hartsfield-Jackson Atlanta International, and La Guardia were delayed by nearly three hours, over 2.5 hours, and about an hour, respectively, the FAA reported as of Saturday afternoon.
With the Thanksgiving holiday approaching on 27 November, it’s one of the busiest travel seasons of the year in the US.
It’s not just commercial flights that have been affected. Restrictions on private jets are also in place, Secretary Duffy said in a Saturday post on X.
“We’ve reduced their volume at high traffic airports — instead having private jets utilize smaller airports or airfields so busy controllers can focus on commercial aviation,” Duffy wrote. “That’s only fair.”
And things will likely get worse in the coming days as the FAA increases the percentage of cancelled flights.
On Thursday, the agency announced that the flight reductions would be gradual, starting at 4% of flights on Friday before rising to 6% by 11 November, 8% by 13 November, and the full 10% by 14 November.
The FAA said the cuts were necessary to maintain safety as air traffic controllers have been overworked during the shutdown.
As essential workers, the controllers are required to continue working without pay, and as a result, many have called out sick or taken on second jobs to afford necessities, unions say.
The controllers are just some of the 1.4 million federal workers who have either been working without pay or been put on forced during the shutdown.
Another factor impacting air travel is that most of the Transportation Security Agency (TSA) 64,000 agents are also not being paid while the shutdown is in place.
During the previous government shutdown, under US President Donald Trump in 2018, it was found that up to 10% of TSA staff chose to stay at home rather than work for free.
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