The Trump Administration announced agreements with Eli Lilly and Novo Nordisk that pair price cuts on GLP-1 medicines with a federal push to broaden access. In a new insight, Director of Health Care Policy Michael Baker discusses the specifics of the coverage changes, potential costs, and how the process marks a significant end-run around standard Centers for Medicare and Medicaid Services regulations.

Key points:

• The agreement serves to both lower Medicare prices paid by American seniors and invigorate the TrumpRx direct-to-consumer pharmaceutical channel.
• The estimated federal Part D outlay for the injectable GLP-1 products (assuming Medicare’s typical subsidy share) is between $855–$1,743 per new user, per year; thus, every 1 million new users would cost Medicare about $1.74 billion annually (or $0.89 billion at starter-dose pricing).
• The administration’s announcement represents a consequential policy shift on access to anti-obesity therapies, set from the Oval Office rather than through the CMS’ usual benefit and formulary processes.

Read the analysis.