Gallego Presses Eli Lily, Novo Nordisk on Secret Trump Drug Pricing Deal

WASHINGTON - Today, Senator Ruben Gallego (D-AZ) called on drug manufacturers Eli Lilly and Novo Nordisk to clarify the companies' agreement with the Trump administration on anti-obesity medications (AOMs), direct to consumer pricing through the TrumpRx drug purchasing platform, and the implementation of "Most Favored Nation" (MFN) pricing in Medicaid.

READ MORE: Gallego demands answers on Eli Lilly's deal with Trump (The Hill)

"To date, only sparse details have been provided despite the significance of this arrangement for millions of patients," Senator Gallego wrote in letters to Eli Lilly Chair and CEO David Ricks and Novo Nordisk CEO Mike Doustdar. "While I support the expansion of Medicare coverage for anti-obesity medications, it raises concern that few details about this deal have been made public, and that in return for this arrangement, Eli Lilly will receive a three-year exemption from Section 232 tariffs."

The Trump Administration says this deal will make drugs like Zepbound and Mounjaro more affordable. Yet based on publicly available information, substantial questions remain, particularly given that Medicare is already negotiating prices for these medications, and it's not clear how this new deal fits within existing law and the TrumpRx platform's requirement that patients forgo insurance coverage and pay out-of-pocket.

"As currently described, TrumpRx would require patients to bypass their insurance and pay cash for medications - often at high out-of-pocket costs. Given that many insured patients already have lower copays or coinsurance than the proposed TrumpRx discounts, it is unclear how this platform would provide meaningful relief. In fact, it may increase costs for patients," the Senator continued. "Given the significant implications for patients who rely on these medications, it is essential that the details of these agreements be made public."

Gallego asked the companies to clarify:

• The full list of drugs that will be subject to MFN pricing;
• Which comparator countries and pricing benchmarks will be used to determine MFN prices, and whether the companies will publicly disclose the final formula, including discounts or confidential rebate agreements;
• How frequently MFN pricing will be updated, and whether changes will be automatic as international pricing data shifts;
• Whether the companies will commit to not shifting costs onto private insurance markets, employer plans, or Medicare to recoup any revenue loss;
• Plans to expand MFN or TrumpRx-style pricing to commercial markets;
• How this arrangement will change Medicare coverage for AOMs, including which individuals are newly eligible for coverage;
• How the Trump Administration arrived at the $245 price point for AOMs in Medicare and Medicaid; and
• A dose-by-dose price schedule for Zepbound and Mounjaro on TrumpRx, and assurances that patients will not face dramatic price spikes as they move to clinically effective maintenance doses.

Read the letter to Eli Lily HERE.

Read the letter to Novo Nordisk HERE.

Last month, Gallego also called on Pfizer and Astrazeneca to clarify similar questions about the companies' pricing metrics that will be used in the MFN formula and what the full scope of drugs subject to MFN pricing in Medicaid will be.

11/18/25