Last November, President Trump stood in the Oval Office beside executives from Eli Lilly and Novo Nordisk and promised America's seniors more affordable weight-loss drugs. The delivery vehicle is the GLP-1 Bridge Program, launched on July 1 under the leadership of Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz. On paper, it’s quite simple: eligible Medicare enrollees get Wegovy, Zepbound, or the new daily pill Foundayo for a flat $50 a month, through the end of 2027. But here’s the problem—subsidizing GLP-1 medications through taxpayer dollars is a temporary solution less ideal than embracing competition to drive prices down over the long term.
Patients with obesity are at higher risk for diabetes, heart disease, and sleep apnea, conditions which, when developed, balloon costs for the Medicare and Medicaid system and shorten the expected lifespan of Americans.
The GLP-1 Bridge Program makes it clear that CMS recognizes that fighting obesity by using science will both improve patients’ lives and lead to healthcare cost savings down the line.
Making GLP-1 medications more affordable for American seniors and those with disabilities also means that fewer Americans will turn to copycat medications and the illicit GLP-1 market, which have proven to be dangerous.
As the FDA has noted, Americans who turn to the illicit market can have serious adverse effects, often because of issues related to dosage or titration. With GLP-1 medications now more affordable for American seniors and those with disabilities, the pull factor from copycat medications and the illicit market will be severely lessened.
But taxpayer subsidies for GLP-1 medications aren’t a long-term solution, and there are real concerns on patient eligibility and access through the Bridge program. The goal should be to increase access and bring GLP-1 prices down for anyone who could benefit from them, not just those not on Medicare or Medicaid.
So how can we get prices down without turning to taxpayer subsidies?
One avenue is to target the role of pharmacy benefit managers (PBMs), which are companies that manage prescription drug benefits for health insurers and large employers.
They act as middlemen who build the lists of drugs covered by insurance; their incentive to cover a drug is not driven by the lowest final price to the patient. Instead, they are looking for the biggest rebate they can rake in by keeping the difference between a drug's high list price and the manufacturer discounts offered. Those discounts are intended to be passed on to patients, but instead are lining the pockets of PBMs.
If PBMs were paid under a fixed-payment model rather than through rebates, experts estimate this could lower drug prices by up to 15 percent.
On top of that, drug manufacturers and retailers have been in a race to the bottom on prices, described by CNBC as a “gold rush” mentality to reach the lowest possible price everywhere from Walmart to Costco. Novo Nordisk launched its own NovoCare Pharmacy operation in 2025 for cash-paying patients at $499 per month, a big step down from a prior $650 direct-ship price. Eli Lilly launched a self-pay channel for Zepbound single-dose vials to eliminate third-party supply chain costs, thereby lowering the price.
These direct-to-consumer and self-pay innovations are key in helping drive down prices. It only took a year for the cost of Ozempic to crash from $1,350 to around $350 per month. That’s markets at work. But politicians always want to get involved so they can be part of the patient success story and claim their health gains as a victory for election season. The Trump administration has been no different.
If these politicians want a win on the drug price issue, then a long-term solution they should embrace to get GLP-1 prices down for all Americans will come through PBMs reform and more competition, not taxpayer subsidies and more government.
Jay Goldberg is the North American Affairs Manager at the Consumer Choice Center
