By John WilkersonJune 30, 2026
John Wilkerson, a Washington correspondent, is the author of D.C. Diagnosis, a twice-weekly newsletter about the politics and policy of health and medicine.
WASHINGTON — The Trump administration’s grand bargain with drugmakers on GLP-1s was based on a simple premise: lower prices in exchange for higher sales volume. Instead, the companies secured higher volume without the lower prices in some cases.
When President Trump’s team of negotiators got Eli Lilly and Novo Nordisk to agree to a monthly $245 price in Medicare and Medicaid in November, that price was supposed to be for all GLP-1s, including those for obesity, which until then had not been covered by Medicare.
But that price was contingent on private Medicare insurers agreeing to cover the drugs for all uses, with a $50 copay. The administration did not publicly mention that condition, but Novo and Lilly recently confirmed it to STAT.
