As demand for GLP-1 weight-loss medications like Wegovy and Zepbound continues to grow in the United States, so do questions about their affordability and the structural forces driving their sky-high prices. With recent policy action from the Trump administration, drug manufacturers could soon be under more pressure than ever to justify U.S. prices that far exceed international benchmarks.

A global price gap

Novo Nordisk’s Wegovy, a leading GLP-1 drug used for weight management, is priced at approximately $1,349 per month in the United States. In contrast, the same medication costs just $92 in the United Kingdom, according to evidence submitted to the U.S. Senate and reported by USA Today.

This striking price disparity is not unique to Wegovy or the weight-loss category. A key reason, experts say, is the U.S. lacks a centralized authority to negotiate drug prices, a system used effectively in other countries.

Stanford University research says in most developed nations, national health systems negotiate directly with pharmaceutical companies to secure lower prices. In the U.S., however, companies often set prices based on what the market will bear. Additional price drivers include complex patent protections, costly manufacturing, limited insurance coverage and intermediaries like pharmacy benefit managers.

“The drug pricing system in the United States is so byzantine, it’s nearly incomprehensible, and it results in drugs costing two to nearly four times as much as they do in Canada, Mexico, and many European countries,” said Aimee Levitt with the Stanford Business School.

A presidential push for price reform

President Donald Trump signed an executive order on May 12 aimed at closing the price gap between the U.S. and other nations. The order mandates that pharmaceutical companies adjust their pricing to match the “most-favored nation” rate, essentially, the lowest price offered in comparable countries like the U.K. or Germany.

Under the order, drug companies have 30 days to comply or face penalties that might include tariffs or even bans on exporting their products from the U.S. The order could reduce prescription drug prices by up to 80% in the U.S.

The move comes amid growing frustration over the cost of drugs many Americans now consider essential. GLP-1 medications, in particular, have emerged as a promising intervention in a nation where obesity remains a major public health challenge.

“Starting today, the United States will no longer subsidize the health care of foreign countries,” Trump said in announcing the order. “Which is what we were doing, we’re subsidizing others health care countries where they paid a small fraction of what for the same drug. That what we pay many, many times more for and we’re no longer tolerate profiteering and price gouging from big pharma, but again, it was really the countries that forced big pharma.”

Industry response, new pricing models

Pharmaceutical companies have started responding to the pressure. Eli Lilly, maker of Zepbound (tirzepatide), recently announced a “Self Pay Journey Program,” offering 7.5 mg and 10 mg doses for $499 per month.

Novo Nordisk has also indicated a willingness to collaborate with federal policymakers. However, both companies point to systemic inefficiencies, particularly the role of pharmacy benefit managers, as key reasons why U.S. prices remain high.

A high-stakes health issue

Obesity affects 41.9% of U.S. adults over the age of 20, according to data from the Centers for Disease Control and Prevention. The condition is associated with increased risks of type 2 diabetes, cardiovascular disease and certain cancers. As a result, GLP-1 drugs are seen by many healthcare experts as a potential game-changer, if patients can afford them.

With political action underway and industry shifts emerging, the question remains whether these changes will lead to sustained price reductions and greater access for the millions of Americans who could benefit.