It took just one off-hand comment during a White House event about fertility treatments for President Trump to temporarily wipe tens of billions from the market cap of the world’s leading obesity drugmakers. Trump’s vow Thursday to bring Ozempic down to $150 per month, calling it “the fat-loss drug,” sent Novo Nordisk shares down 6.3% and Eli Lilly down roughly 4% on Friday. By Monday, Oct. 20, both had essentially recovered from the drop with Lilly trading at $808.96 and Novo $55.74, both roughly a 1% slide over the past five days.
Negotiations haven’t begun yet
Still, the details of the plan were the latest threats to the incretin drug class, which have been one of the strongest pharma growth drivers in recent years. The details of the plan are scarce at the moment. When a reporter asked if weight-loss drugs would cost “$150 out of pocket,” Trump mentioned Ozempic by name, prompting Mehmet Oz, Administrator for the Centers for Medicare & Medicaid Services, to step forward noting: “We have not negotiated those yet. We’re going to be rolling these out over time. The [GLP-1] category of drugs, which includes Ozempic, have not been negotiated,” Oz said. Trump added: “but we will” without offering a timeline.
Four of the world’s top-10 drugs generated $31.2 billion in H1 2025 alone and are tracking toward a $62.4 billion annualized run rate.
After rebates, insurers pay $6,800-$8,000 annually for GLP-1s (blue bars), close to ICER’s $100,000-per-QALY value threshold (orange bars). Trump’s $150/month pledge ($1,800/year) would represent an 73-78% cut from these net prices, pushing costs well below what health economists consider cost-effective for obesity treatment. Source: ICER
Why $150 would be significant
The figure, if implemented, would require cuts of roughly 70-75% from current net prices, not just list prices. Independent analysis from the Institute for Clinical and Economic Review (ICER) estimates that after rebates, U.S. net annual prices for semaglutide run around $6,830 and tirzepatide $7,973, or roughly $569-$664 per month. Hitting $150 could mean slashing prices well below what insurers currently pay behind the scenes, far deeper than the step down to today’s $499 cash programs that both companies launched earlier this year.
Wall Street called the selloff “overdone.” BMO Capital Markets analysts noted that “with insured individuals in the US already paying as low as $25/month for GLP-1 medications, we continue to view any ultimate negotiated MFN price as more of a headline risk versus a true fundamental change” to the companies’ businesses. JPMorgan analysts said they “see President Trump’s comments as in line with our expectations for the price negotiation” and “see no downside to our numbers from the price points he mentioned.” Mizuho strategist Jared Holz suggested Trump’s comments were “more to get these guys to make a deal than to actually get the price to $150 over the short term.”
Lilly’s Zepbound (tirzepatide) achieved 17.5% placebo-adjusted weight loss at one year, outperforming Novo’s injectable Wegovy (13%) and oral semaglutide (11%) in clinical trials. The efficacy gap helps explain why Lilly has been gaining market share, but also why both drugs command premium pricing. Source: Institute for Clinical and Economic Review (ICER)
The compounder irony
The $150 target undercuts a legal strategy both companies just won. Throughout 2024 and 2025, Lilly and Novo waged aggressive litigation campaigns to shut down compounding pharmacies selling knockoff versions of their drugs for $130-200 per month, arguing the copycat products posed safety risks and violated FDA rules. Federal courts sided with the drugmakers earlier this year, forcing compounders to cease production of semaglutide and tirzepatide by April-May 2025 after the FDA formally ended shortage declarations for both drugs. Novo CEO Lars Fruergaard Jorgensen told investors in March that compounders were “damaging our business” and expressed hope patients would return to branded products once the copycats disappeared.
Now Trump’s $150 pledge threatens to make that legal victory pyrrhic. If branded drugs hit $150, roughly the midpoint of what compounders charged, the companies’ entire rationale for shutting down low-cost alternatives evaporates. Telehealth companies like Hims & Hers, which sold compounded GLP-1s for under $200 per month, saw shares plunge more than 15% Friday as investors realized a $150 branded price would obliterate their business model.
ICER’s base-case analysis finds tirzepatide costs $53,000 per quality-adjusted life year (QALY)—below both Wegovy ($61,000/QALY) and oral semaglutide ($69,000/QALY). Greater weight loss per dollar makes Lilly’s drug the value leader, though all three exceed common cost-effectiveness thresholds. Source: ICER
Filed Under: Metabolic disease/endicrinology
