Lilly and US government agree to expand access to obesity medicines

Eli Lilly and Company has announced an agreement with the US government to expand access to its obesity medicines and reduce patient costs. In 2020, Lilly partnered with the Trump Administration on a pilot programme that paved the way for Lilly to be the first company to cap out-of-pocket insulin costs at $35 per month.

Lilly will now improve access to nearly 40 million Americans living with obesity on government insurance programmes and millions more who pay out-of-pocket. Unlocking access to these medicines can be game-changing for Americans with obesity – a risk factor driving more than 200 associated diseases, including heart disease, strokes and certain types of cancers.

"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 US healthcare system, and contributing to the health of our nation for generations to come," said David A. Ricks, Lilly chair and CEO. "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."

Starting as early as April 2026, Medicare beneficiaries will pay no more than $50 per month for Zepbound (tirzepatide), available in a multi-dose pen, and for orforglipron, Lilly's convenient once-daily obesity pill, provided both receive approval from the FDA. Individual states will also have the ability to expand access to Zepbound and orforglipron through Medicaid.

Lilly applied for the Commissioner's National Priority Voucher for orforglipron, potentially accelerating FDA approval. Upon FDA approval, self-pay patients living with obesity will be able to access these medicines through LillyDirect's self-pay pharmacy channel.

Zepbound multi-dose pen will be available at the lowest dose at $299, with additional doses up to $449 representing a $50 discount to current direct-to-patient prices; priced similar to what is available in Europe. When patients refill their multi-dose pen prescription on the LillyDirect digital health platform, they will pay no more than $449. Orforglipron will be available with the lowest dose starting at $149 with additional doses up to $399.

The scope of the agreement does not include pricing obligations in the commercial channel.

Emgality (galcanezumab-gnlm), Trulicity (dulaglutide) and Mounjaro (tirzepatide) will be added to LillyDirect and made available for self-pay patients with pricing 50-60% off their current list prices.

Lilly will also continue to offer insulin at no more than $35 per month out-of-pocket, whether a person has commercial insurance or no insurance.

"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," Ricks added. "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."

The announcement also reflects Lilly's commitment to strengthening US life sciences through significant investments in manufacturing and research and development. As part of its industry-leading commitment to US-based innovation and scientific progress, the company is investing more than $50 billion in US manufacturing to boost domestic production in key therapeutic areas.

As part of the agreement, Lilly is addressing all four of the Administration's priorities, including launching new medicines with a more balanced pricing approach across developed nations. In return, Lilly will receive three years of tariff relief and will not be subject to future pricing mandates.

The Obesity Action Coalition (OAC) has welcomed this announcement to significantly lower the cost of several FDA-approved medications, including those used to treat obesity. Under the new agreements, Medicare beneficiaries will pay a co-pay of just $50 per month, making these life-changing treatments more affordable and accessible, and opening the door for Medicare and Medicaid to cover obesity drugs for adults. For years, the OAC has advocated for affordable access to obesity treatments and equitable coverage across all payers - including Medicare, Medicaid and private insurance.

"The OAC has long urged leaders across government and healthcare to make obesity care accessible and affordable," said Joe Nadglowski, OAC President and CEO. "Today's announcement represents a meaningful step toward improving access to evidence-based treatment options for millions of Americans living with obesity. Continued collaboration among policymakers, insurers, healthcare providers and systems will be critical to ensuring these changes reach everyone who needs them."

The OAC emphasises that expanding access to obesity medications is a crucial part of addressing one of the nation's most prevalent and costly chronic diseases. Lowering drug prices, improving insurance coverage and recognizing obesity as a serious, chronic disease are essential steps toward improving health outcomes and quality of life for millions of Americans.