Eli Lilly and Company announced an agreement with the U.S. government that will expand access to its obesity treatments for Medicare beneficiaries and self-pay patients, resulting in significantly reduced monthly out-of-pocket costs.
The initiative is aimed at increasing availability of medications such as Zepbound and the investigational oral obesity treatment orforglipron, pending U.S. Food and Drug Administration approval. The agreement reflects a broad public-private effort to address obesity, which affects nearly 40 million Americans on government insurance programs and is associated with heightened risks of more than 200 medical conditions, including cardiovascular disease and certain cancers.
The expansion follows Lilly’s prior collaboration with the federal government in 2020, which resulted in the company becoming the first to cap out-of-pocket insulin costs at $35 per month. Once effective, Medicare beneficiaries with obesity or overweight who are prescribed Zepbound or orforglipron will pay no more than $50 monthly beginning as early as April 1, 2026. States will also have the option to expand access to both medicines through Medicaid programs.
For self-pay patients, Lilly will provide access through LillyDirect, its digital pharmacy platform. Zepbound, available in a multi-dose pen, will be priced starting at $299 for the lowest dose and up to $449 for higher doses. Patients refilling through LillyDirect will pay no more than $449. Orforglipron will start at $149 for the lowest dose and up to $399. Additional Lilly medicines such as Emgality, Trulicity, and Mounjaro will also be added to LillyDirect at prices 50 to 60 percent lower than their current list prices. The agreement does not impose pricing requirements in the commercial insurance market. Lilly will continue offering insulin for no more than $35 per mont,h regardless of insurance coverage.
The company stated that the partnership is part of a broader effort to rebalance global drug pricing and strengthen U.S. manufacturing capacity. Lilly is currently investing more than $50 billion in domestic manufacturing to support production in major therapeutic categories. As part of the agreement, the company will align new medicine pricing approaches across developed nations and will receive three years of tariff relief while avoiding future pricing mandates.
Orforglipron is an investigational once-daily oral glucagon-like peptide-1 receptor agonist that does not require restrictions on food or water intake. Initially discovered by Chugai Pharmaceutical Co., Ltd. and licensed to Lilly in 2018, the medicine is being evaluated in Phase 3 trials for type 2 diabetes, weight management, and multiple obesity-related conditions, including obstructive sleep apnea, hypertension, and osteoarthritis pain.
KEY QUOTES
“Today marks a pivotal moment in U.S. health care policy and a defining milestone for Lilly, made possible through collaboration with the Trump Administration. As we expand access to obesity treatments for more Americans and advance one of the most innovative obesity pipelines, we remain focused on improving outcomes, strengthening the U.S. healthcare system, and contributing to the health of our nation for generations to come.”
“This agreement adds to our established commitment to affordability – from being the first company to cap insulin prices at $35 to launching LillyDirect, the end-to-end digital healthcare experience.”
“The U.S. health care system has evolved in a way that’s unfair to American patients and taxpayers who disproportionately pay a higher share of the costs for developing breakthrough medicines compared to other countries. Lilly is in a unique position to work with the U.S. government to rebalance the global system, expand access and lower costs for Americans while also protecting our company’s ability to both innovate and enhance manufacturing capacity to meet the significant demand for our life-saving medicines.”
David A. Ricks, Lilly Chair and CEO
