The federal government has announced plans to lower the costs of GLP-1 anti-obesity medications. However, the exact impact these plans will have on employer-sponsored health insurance is still unclear. The White House announced that Novo Nordisk and Eli Lilly have agreed to sell their GLP-1 obesity drugs at substantially lower prices to Medicare and Medicaid. The White House also announced lower direct-to-consumer prices (DTC) for drugs purchased without insurance through the platform, TrumpRx.gov, which is expected to go live January 2026. Pricing for select GLP-1 medications from the press release include:
TrumpRx is a navigator platform and will refer purchasers to drug manufacturer websites and isn't a separate discount program. As such, prices passed through are expected to fluctuate. Other major drug manufacturers have agreed to participate as well. Pfizer said it will offer many primary care treatments and certain specialty branded drugs on the TrumpRx website at discounts of 50% on average and up to 85%.
The move toward DTC access should not be viewed as a short-term marketing trend, but rather a strategic reconfiguration of the pharmaceutical value chain. As of Q3 2025, the LillyDirect DTC channel comprises 45% of new prescription volume for their obesity medication, Zepbound.
Over the next few years, we expect continued growth of DTC programs where convenience and affordability drive self-service models. DTC models let manufacturers control pricing, data ownership and delivery. This changes the traditional role of pharmacy benefit managers (PBMs) as intermediaries. The launch of TrumpRx further underscores growing policy support for bypassing PBMs entirely.
The ripple effects of DTC expansion extend across employers, PBMs and the broader benefit-management landscape. For employers, DTC introduces potential cost savings, but also a new source of benefit fragmentation. When employees purchase drugs directly, those transactions fall outside plan reporting. Over time, this can distort trend analytics and make it harder to measure the success of pharmacy benefit strategies. It also complicates employee communications, as members may not understand which drugs are paid for by their employer, or why purchases made through a DTC site don’t accumulate toward deductible thresholds.
There will be substantial pressure on Novo and Lilly as well as the PBMs to make GLP-1 obesity treatments available through employer benefits at prices similar to those offered direct to the consumer. Otherwise, more employers will exclude coverage, and some might seek to reimburse members who purchase the drugs via the lower DTC self-pay option. Unfortunately, this will mean that lower-wage employees who can’t afford the upfront cost will be less likely to obtain the benefits from GLP-1 medications.
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