Eli Lilly’s CEO says upcoming Medicare coverage of obesity drugs could transform the market, sharply lowering costs and accelerating the launch of the company’s closely watched weight loss pill.
WEBDESK – Act Global Media
A long-awaited shift in U.S. health policy could dramatically reshape the weight loss drug market, according to Eli Lilly and Company CEO Dave Ricks, who says upcoming Medicare coverage of obesity medicines may be a game changer for the company’s experimental pill, orforglipron.
Speaking in an interview on Friday, Ricks said Lilly expects Medicare coverage to begin immediately after the drug’s anticipated launch later this year, opening access to millions of older Americans for the first time. “That will change the game,” he said, pointing to the high out-of-pocket costs many patients currently face.
The rollout of orforglipron is expected to coincide with Medicare covering obesity treatments under pricing agreements struck last November between major drugmakers and President Donald Trump. The policy shift marks the first time Medicare will broadly cover medicines aimed specifically at weight loss.
Ricks noted that many patients are currently paying cash for a competing oral obesity drug from Novo Nordisk, which launched earlier this month with limited insurance coverage but strong early demand. He said most of those early users are new to GLP-1 treatments, suggesting the market is expanding rather than simply shifting patients from injections to pills.
“It’s reaching more patients, and that’s a good thing,” Ricks said, adding that Lilly is confident its pill can compete as the company prepares for a full commercial launch in the second quarter of the year.
Under the new Medicare framework, eligible patients could pay as little as $50 per month for approved injectable and oral GLP-1 drugs used to treat diabetes and obesity. Ricks said that the lower price point is expected to take effect in the second half of the year and could significantly broaden access.
Health experts have long argued that Medicare coverage could unlock wider adoption of obesity treatments and pressure private insurers to follow suit. Ricks estimates that between 20 million and 30 million Medicare beneficiaries living with obesity or related conditions could qualify for GLP 1 therapy, calling coverage “a big multiplier” for the potential patient pool.
The pricing deals do involve reduced margins in the near term, Ricks acknowledged, as drugmakers voluntarily lower prices and align with so-called most-favored-nation benchmarks. Still, he said Lilly expects volume growth to accelerate later in the year as coverage expands and awareness grows.
Lilly plans to outline the financial impact of the agreements when it reports fourth quarter earnings and provides its 2026 outlook next week.
The deals also include commitments to offer discounted cash pay options through President Trump’s planned direct-to-consumer platform, TrumpRx, which has yet to launch. Ricks said Lilly’s own direct platform, LillyDirect, paved the way for that model and welcomed the broader industry push.
“We’re all for expanding access,” he said.
