New Pricing Agreements Aim to Lower Costs of Popular Weight Loss Drugs

What Is the Trump Drug Pricing Agreement?

On November 6, 2025, President Donald Trump announced a landmark pharmaceutical pricing agreement with Eli Lilly and Novo Nordisk that will reduce costs for widely prescribed weight loss and diabetes medications. This deal represents a major implementation of Most-Favored-Nation (MFN) pricing policy and is projected to launch through the TrumpRx direct-to-consumer platform in 2026. The agreement follows the first deal announced by the Trump administration in September with Pfizer.

How Much Will GLP-1 Drugs Cost Under the Trump Agreement?

While the new pricing is significantly lower than list price, calculating the true impact requires a detailed look at the numbers. The following breaks down the cost and potential savings for key medications.

GLP-1 Drug Pricing Comparison

These reduced prices are slated to be available starting in 2026 through the federal TrumpRx website, though employers should anticipate impact on their pharmacy benefits much sooner.

What Is Most-Favored-Nation (MFN) Pricing?

Most-Favored-Nation pricing is a policy mechanism that ties U.S. drug prices to the lowest prices paid by other developed nations. The Trump administration's May 2025 executive order directed implementation of MFN pricing, and this November agreement marks one of the first major enforcement actions.

Should Employers Cover GLP-1 Drugs for Weight Loss in 2026?

This is the most pressing question facing HR and benefits leaders. The answer depends on your organization's financial capacity, population health strategy, and competitive positioning.

Benefits of Covering GLP-1 Medications for Weight Loss

1. Population Health Improvements

• Reduces cardiovascular disease risk by 15-20%
• Prevents or delays type 2 diabetes onset
• Improves outcomes for sleep apnea and joint health

2. Long-Term Cost Savings

• Potential 10-15% medical cost offset over 3-5 years
• Reduces downstream expenses for diabetes, cardiovascular events, and bariatric surgery

3. Workforce Benefits

• Improved productivity and reduced absenteeism
• Enhanced talent attraction and retention
• 60%+ of tech and professional services firms now cover GLP-1s for weight loss

Risks and Challenges of GLP-1 Coverage for Weight Loss

1. Budget Impact

• For a 1,000-employee organization, potential annual cost of $360,000-$600,000 if 10% utilize
• Requires long-term financial commitment as medications need indefinite use

2. Operational Complexity

• Requires robust prior authorization and clinical monitoring
• Administrative burden on HR and benefits teams
• Need for integrated weight management programs

How Will Medicare and Medicaid Coverage Affect Employers?

Currently, Medicare Part D plans cannot cover GLP-1 drugs solely for weight loss, and fewer than 15 states provide Medicaid coverage. The Trump administration's reduced pricing may accelerate public program coverage expansion, creating:

• Pressure on employers to match Medicare benefits for pre-65 retirees
• Shifts in what constitutes "competitive" benefits
• More complex coordination of benefits scenarios

What Is TrumpRx and How Does It Work?

TrumpRx is a direct-to-consumer pharmaceutical purchasing platform scheduled to launch in 2026. The platform will allow Americans to purchase participating medications at negotiated prices directly, bypassing traditional pharmacy benefit channels.

Will employees use TrumpRx instead of employer plans?

Employee decision-making will depend on several key factors:

• Comparative out-of-pocket costs
• Whether TrumpRx medications count toward deductibles
• Integration with HSAs and FSAs

Employer Action Plan: What to Do Now

The Trump drug pricing agreement creates urgency for employers to evaluate their GLP-1 coverage strategy before 2026 implementation, but rushing into decisions without proper analysis can lead to costly mistakes. Follow this phased approach to make informed decisions aligned with your organization's financial capacity and employee health objectives.

Immediate Actions (Next 30-90 Days)

1. Conduct population health data analysis: Review BMI distribution and obesity-related conditions
2. Request PBM modeling: Get utilization and cost projections specific to your population
3. Review current coverage policies: Audit prior authorization criteria for GLP-1 medications
4. Assess financial capacity: Model 3-year budget impact across multiple scenarios

Short-Term Actions (3-6 Months)

1. Develop coverage philosophy: Define position on weight loss vs. diabetes-only coverage
2. Design utilization management: Implement clinical criteria and prior authorization protocols
3. Plan integrated programs: Include nutrition counseling, behavioral health, and activity coaching

Medium-Term Actions (6-12 Months)

1. Communicate with stakeholders: Brief leadership and develop employee communications
2. Prepare for 2026 enrollment: Update benefits guides and SPDs
3. Monitor TrumpRx implementation: Track federal rollout and employee interest

Industry Coverage for Weight Loss Trends by Sector

While many employers share core challenges, coverage needs and plan adoption rates vary significantly by sector. The following provides a detailed look at the trends emerging across key industries.

Technology and Professional Services (60-70% covering)

• View as essential preventive care
• Focus on talent retention

Financial Services (40-50% covering)

• Measured approach with robust utilization management
• Emphasize integrated program requirements

Manufacturing and Retail (20-30% covering)

• Conservative due to cost sensitivity
• Often limit to diabetes indications

By Organization Size:

• Large employers (5,000+): Most likely to cover with sophisticated management
• Mid-size (1,000-5,000): Split decisions, watching peers
• Small (less than 1,000): Least likely; concerned about budget volatility

Navigating the New GLP-1 Landscape

The Trump drug pricing agreement has the potential to fundamentally change the GLP-1 coverage landscape for employers:

Immediate Impact:

• Lower drug costs remove a key barrier to utilization
• Expect increased employee requests and pressure to cover
• Need for proactive decision-making on coverage strategy

Long-Term Considerations:

• Population health investments today may reduce downstream costs
• Coverage decisions signal organizational values on employee wellbeing
• Competitive benefits landscape is evolving rapidly

Critical Success Factors:

• Robust financial modeling across multiple scenarios
• Comprehensive utilization management and clinical support
• Integration with broader wellness and disease management programs
• Clear communication with employees about coverage and access

Frequently Asked Questions

When will TrumpRx launch?

The platform is scheduled to launch in 2026, though exact timing has not been announced.

Will the Trump drug pricing apply to employer health plans?

The announced prices are for direct-to-consumer purchases through TrumpRx. Employer plan prices depend on PBM negotiations, though these deals may create new pricing benchmarks.

How many employers currently cover GLP-1s for weight loss?

Approximately 40-45% of large employers offer some coverage for weight loss indications, with significant variation by industry sector.

What is the ROI timeline for GLP-1 coverage?

Most medical cost offsets don't materialize until year 3-5 of coverage. Near-term (1-2 years) will see net cost increases.

Can employees use TrumpRx if my plan doesn't cover GLP-1s?

Yes, TrumpRx is a cash-pay platform available to all Americans regardless of insurance coverage.

Next Steps for Employers

The decisions you make regarding GLP-1 coverage will have multi-year financial and strategic implications. Consider the following to ensure your organization is prepared for this shifting regulatory and market landscape:

1. Don't wait for perfect information - Make decisions with best available data
2. Prioritize utilization management - Coverage without clinical criteria leads to poor outcomes
3. Think total cost of care - Model medical offsets, not just pharmacy trend
4. Communicate transparently - Employees appreciate honest discussions about limitations
5. Partner with clinical experts - Obesity requires sophisticated management

Ongoing support and evaluation from your dedicated consulting team will be key to staying up to date in this rapidly evolving landscape. For more insights on employer-sponsored pharmacy benefits, check out our whitepaper on whether employers should cover GLP-1 drugs for weight loss.

Reach out to our OneDigital Pharmacy Consulting team to develop a customized approach that balances fiscal responsibility with employee health objectives.