Weight loss drugs see policy turning point: U.S. Medicare covers GLP-1.

After reaching a price reduction agreement with the Trump administration, the Centers for Medicare and Medicaid Services (CMS) in the United States announced on Tuesday the launch of a voluntary program that will include GLP-1 class weight loss and diabetes treatment drugs in the coverage of Medicaid and Medicare Part D. It is understood that in November of this year, President Trump signed agreements with Eli Lilly (LLY.US) and Novo Nordisk A/S Sponsored ADR Class B (NVO.US), promising to significantly reduce the prices of popular GLP-1 weight loss drugs for federal Medicare, Medicaid programs, and self-pay patients. The new program launched by CMS is based on this agreement and is expected to start for Medicaid programs as early as May 2026 and expand to federal Medicare in January 2027. According to the "BALANCE Initiative," CMS will lock in drug net prices through direct negotiations, establish standardized coverage terms, or set limits on patient out-of-pocket costs, and provide evidence-based lifestyle support services. CMS explicitly stated that eligible federal Medicare enrollees will only need to pay $50 per month to access GLP-1 class drugs, including Novo Nordisk A/S Sponsored ADR Class B's weight loss injection Wegovy (semaglutide) and Eli Lilly's similar drug Zepbound (tirzepatide). To transition smoothly to the "BALANCE Initiative" model, CMS plans to launch a federal Medicare GLP-1 drug payment pilot program in July 2026, allowing enrollees to purchase related drugs at negotiated government prices. CMS Director Mehmet Oz posted on social media platform X that the program is "aimed at increasing access to specific GLP-1 class drugs and helping people adopt healthy lifestyle habits." According to CMS, drug manufacturers, state governments, and insurance plans can voluntarily participate in the project. It was revealed in the November agreement with the Trump administration that two eagerly anticipated oral weight loss drugs being developed by Eli Lilly and Novo Nordisk A/S Sponsored ADR Class B would be priced at $149 per month for federal Medicare and Medicaid enrollees and self-pay patients. It is worth noting that Novo Nordisk A/S Sponsored ADR Class B's oral weight loss drug was approved for market on Monday, while Eli Lilly's similar drug is still in the approval process. The Trump administration also pointed out that for GLP-1 class injectable drugs currently on the market for diabetes and other covered indications, the monthly medication cost for federal Medicare and Medicaid enrollees will drop to $245.