GLP-1 Drugs and TrumpRX: What This Means for You
November 19, 2025GLP-1 Drugs and TrumpRX: This article discusses an important development regarding treatment options available to individuals with limited or no coverage for the most effective weight loss medications as of 2025. This article is not intended to be political in any form.
On Thursday, November 6th, 2025, the Trump administration made a significant announcement regarding the reduction in pricing for injectable medications and future oral formulations. Before examining the details, let's review the history surrounding the development, release, and costs of providing GLP-1 medications such as Wegovy and Zepbound.
The Evolution of GLP-1 Medications
The use of injectable GLP-1 medications for diabetes management began in 2005 with the FDA approval of Byetta (exenatide). Semaglutide (brand name Wegovy) and Tirzepatide (brand name Zepbound) were approved by the FDA for weight management in 2021 and 2024, respectively. The "Ozempic weight loss craze" started in December 2021 when numerous celebrities endorsed its use for weight loss. When Wegovy received FDA approval, the cost of a one-month supply for patients without insurance coverage was approximately $1,350 for Wegovy and $1,086 for Zepbound.
Understanding Development Costs
It's essential to recognize that these medications didn't emerge overnight, and the process of discovering, developing, and marketing a medication is extremely expensive. Both pharmaceutical companies invested nearly $10 billion into the research and development of these medications, including constructing manufacturing facilities designed to meet growing demand.
The Shortage Crisis and Compounding Solutions
When demand exceeded availability, Novo Nordisk and Eli Lilly couldn't maintain adequate supply, resulting in these medications being placed on the FDA shortage list. This situation created an opportunity for compounding pharmacies to provide the necessary manufacturing capacity, keeping the medication accessible. Prescriptions for compounded weight loss medications increased to 80 million in 2024. The average price for the highest dose of compounded semaglutide was approximately $279 to $400 per month, compared to $1,350 for the brand name. The average price for the highest dose of compounded Tirzepatide was approximately $299 to $399 per month, compared to $1,086 for the brand name.
The shortage of GLP-1 manufacturing ended around April 2025, and compounded medications were no longer an option. Both Eli Lilly and Novo Nordisk began offering less expensive alternatives delivered directly to consumers. For patients without insurance coverage, they could purchase the lowest dose of Zepbound for $349 and all other doses for $499. In the case of Wegovy, patients could buy the medication out-of-pocket for $499, which applied to all doses.
The Medicare and Medicaid Challenge
The most significant challenge was that Medicare didn't cover medications specifically indicated for weight loss. This created an ethical dilemma since Medicare recipients—those who would benefit most from losing weight and improving associated health conditions—found these medications financially inaccessible in most cases.
Medicaid presents a different challenge. Unlike Medicare, which is a federal program, Medicaid is a state-sponsored program with variable coverage. As of 2025, approximately 13 states offered Medicaid recipients coverage for GLP-1 medications specifically for weight loss management, as opposed to diabetes treatment.
The TrumpRX Proposal: Most Favored Nation Pricing
The recently announced TrumpRX proposal represents a novel approach to reducing medication costs by utilizing Most Favored Nation (MFN) pricing. When a drug is sold to a developed country outside the United States, that country can negotiate a price directly with the drug manufacturer. The result is typically a much lower price for that particular country compared to what American consumers pay. This concept has existed for decades and has unfortunately made many medications inaccessible to Americans.
Attempts to use MFN pricing for negotiating drug prices were proposed in 2020, focusing on Medicare Part B drug prices. These attempts were challenged in court and didn't resurface until the current administration used executive orders to bring pharmaceutical companies back to the negotiating table.
What TrumpRX might mean for Patients
For individuals who lack coverage and don't have Medicare or Medicaid, the TrumpRX pharmacy will allow those paying out-of-pocket to receive weight loss medications for approximately $250 per month (Wegovy) to $345 per month (Zepbound). In the near future, once the FDA approves oral versions of GLP-1 medications, the cost will be capped at $149 per month.
Looking Forward
American consumers will finally begin to experience the benefit of nationally negotiated prices for brand-name medications, similar to other advanced nations. Physicians will be able to prescribe the most efficacious medications for their patients, knowing that a greater number of them will be able to afford these medications and follow the recommended treatment course. While this positive development is a welcome relief, we must acknowledge that a significant number of people still won't be able to afford the out-of-pocket cost. It's easy to focus on what could have been better, but this development represents a substantial advancement for those struggling with obesity and associated comorbidities such as diabetes, high blood pressure, and sleep apnea.
This article is for informational purposes only. Please discuss with your healthcare provider if you have further questions.
Stay Healthy, Stay Strong!
Dr. Leon Katz
Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss at Dr. Leon Katz Medical Weight Loss Center.
 | ABOUT THE AUTHOR Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss. He focuses on patients seeking alternatives to surgery and those needing care after bariatric procedures. Dr. Katz was recently the director of a major medical weight loss program. With extensive experience in establishing successful weight management programs, he now concentrates exclusively on non-surgical weight loss solutions. Dr. Katz is a Diplomate of the American Board of Obesity Medicine and Fellow of American College of Surgeons. Dr. Katz currently practices at Dr. Leon Katz Medical Weight Loss Center.Read more articles by Dr. Katz! |
