Will Wegovy, Ozempic and Zepbound become 80% Cheaper? New Executive Order Targets Reducing GLP-1 Prices in the USA

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GLP-1 medications were cited as a main example today when Trump signed an executive order saying people in the US should pay the same price to pharma companies as what people in other countries pay for the same medications. I have to agree with the main point in that there hasn't been a great explanation for patients about why people in the US have to pay 5 times as much as people in other countries for the exact same medication.

The order, experts say, is a reimagined and far more aggressive version of Trump’s policy during his first term to cut drug costs, which failed to take effect after a federal judge blocked it.

The administration hasn’t singled out a specific class of drugs for price cuts, but officials said it’s fair to expect that GLP-1s — a class of drugs that includes Ozempic, Wegovy and Zepbound — will be included among them. 

The executive order signed today will kick off a round of negotiations with pharma companies who will likely push back on this saying they need to cover their R&D costs.

But I think it is great that the spotlight has been put on this issue.

The central issue is a stark difference in pricing structures. US list prices for these GLP-1 medications are exceptionally high, typically ranging from approximately $935 to $1,349 per month.These figures stand in sharp contrast to prices observed in comparable international markets, where the same medications often cost four to five times less, or even lower in some instances.For example, the US list price for Ozempic ($936) is reported to be over five times higher than in Japan ($169), and the US list price for Wegovy ($1,349) is nearly four times higher than in Germany ($328). 

While various patient assistance programs, manufacturer savings cards, and direct-purchase options exist in the US, significantly reducing out-of-pocket costs for certain patient segments – potentially down to $25 per month for some commercially insured individuals or around $499 per month for self-pay vial purchases – these mechanisms do not alter the fundamental high price structure that burdens the overall US healthcare system.This creates a complex landscape of access, where affordability varies dramatically depending on insurance status, income, and program eligibility.  

Novo Nordisk (maker of Ozempic and Wegovy) and Eli Lilly (maker of Mounjaro and Zepbound) dominate this multi-billion dollar market. Their pricing strategies appear tailored to exploit the unique dynamics of the US market, characterized by a lack of centralized government price negotiation power compared to peer nations.Other contributing factors to the high US prices include complex patent strategies employed by manufacturers to potentially extend market exclusivity and a pharmaceutical business model increasingly focused on maximizing shareholder returns. 

Ultimately, the substantial price differential for these highly effective medications raises critical questions regarding patient access, health equity, and the sustainability of healthcare spending in the United States compared to its international counterparts.

We personally wonder if GLP-1s were 80% less expensive if 20 million more people might take them and if people would take them for longer. If so, the pharma companies would ultimately likely make a lot more money and millions more people would benefit.