President Donald Trump has already begun targeting Joe Biden’s drug pricing policies, using an executive order to roll back a 2022 policy that set up new ways for Medicare and Medicaid to pay for expensive medications. The early focus is spooking some lawmakers about the future of Medicare price negotiations for one expensive and popular class of drugs in particular: GLP-1 inhibitors like Ozempic and Wegovy.
“We have made progress in negotiating prescription drug pricing through Medicare. It’s imperative that it be continued,” Sen. Bernie Sanders, the top Democrat on the Health, Education, Labor and Pensions Committee, told NOTUS.
“For years, Trump has campaigned on the reality that we pay by far the highest prices in the world for prescription drugs,” Sanders added. “At this point, at least, Trump is giving the message that he’s going to move in the wrong direction. It takes guts to stand up to Pharma. We will see whether Trump can do that.”
Another HELP member, Democratic Sen. Lisa Blunt Rochester, told NOTUS that she was “watching out” for what the Trump administration does on Medicare price negotiations on GLP-1s.
“I know that the American people are very pleased that we’re doing this. It affects so many millions of people, and so we’re hopeful,” Blunt Rochester said. She added that part of why she wanted to be on the HELP committee “was to be able to fight for these lower costs for drug prices.”
GLP-1 inhibitors are used to treat chronic conditions like diabetes, as well as for prevention of heart attacks and strokes. They can also be used for weight loss, but Medicare is currently prohibited by law from covering medications that treat obesity — though last November the Biden administration proposed removing that restriction.
That expansion would allow millions more people to access GLP-1 inhibitors, but it would also increase Medicare’s spending by an estimated $25 billion over the next decade. The high price of GLP-1 inhibitors is already straining Medicare: The program spent $4.6 billion on Ozempic for enrollees with diabetes in 2022.
One avenue the government could take to make GLP-1 inhibitors less expensive for patients on Medicare is the price negotiation program set up by the Inflation Reduction Act. The Biden administration announced that Wegovy and Ozempic would be included in the list of drugs in the second round of negotiations. But it’s unclear whether the Trump administration will continue with those negotiations later in 2025 as planned. A White House spokesperson did not respond to a request for comment.
“That work has to be done. It’s a big concern,” Sen. Cory Booker said when asked about the threat of the Trump administration impeding Medicare drug price negotiations.
“That was a pretty hard-fought negotiation to get to those 10 drugs, and I think broadly popular with the public,” Rep. Ami Bera said. Trump, he said, “talks about wanting to lower drug prices. I’m not sure what he’s going to do — unless a month from now he reimplements it and says it’s his, which I can see.”
Cristy Gallagher, a spokesperson for the Obesity Care Advocacy Network, which has asked Trump to finalize Biden’s proposal that Medicare cover drugs that treat obesity, told NOTUS the organization would be “disappointed” if the Trump administration were to stall the price negotiations.
“These medications are not weight-loss drugs. They are not drugs that are specific for just sort of losing a little bit of weight. They are designed for the treatment of obesity, and we hope that the Trump administration and the incoming head of HHS and CMS sees this and understands how important this is to millions of older Americans who have been waiting for this coverage,” Gallagher said. “It’s unfair that they can have it under their private insurance, and then when they become Medicare age, they are no longer covered.”
Trump’s nominees to key health roles appear to hold conflicting views on using GLP-1 inhibitors to treat obesity. His nominee for health and human services secretary, Robert F. Kennedy Jr., has been critical of the drugs and the companies that manufacture them in the past, telling Fox News before the election that “if we just gave good food, three meals a day, to every man, woman and child in our country, we could solve the obesity and diabetes epidemic overnight,” and that Novo Nordisk, the maker of Ozempic, is “counting on selling it to Americans because we are so stupid and so addicted to drugs.”
In December, Kennedy appeared to walk back some of those views, saying GLP-1 inhibitors have “a place” in confronting the obesity epidemic alongside lifestyle and diet interventions. Kennedy did not respond to a request for comment.
But Trump’s nominee for director of the Centers for Medicare and Medicaid Services, Mehmet Oz, has been very supportive of GLP-1 inhibitors. In a video posted to social media in 2023, Oz said, “I’ll respect you or whatever weight you want to be at. That stated, if you want to lose weight, I should support you in every way possible. And I think this new generation of medications offers us a huge opportunity.”
Oz has also advocated replacing traditional Medicare plans with private Medicare Advantage plans that could cover all Americans not on Medicaid through a 20% payroll tax split between employers and employees. This plan has come under scrutiny from Democratic lawmakers who say Medicare Advantage plans overcharge CMS. They’ve also criticized Oz’s financial connections to large insurers like UnitedHealth Group, claiming it poses a conflict of interest with his nomination to lead CMS.
Oz has not publicly responded to these accusations, and did not respond to a request for comment. But in his social media video about the benefits of GLP-1 inhibitors, he said, “Shaming someone does not help their health, in my opinion, ever. What does work is getting smart about why they’re having the problem, making it as easy as possible for them to do the right thing, because then they will.”
Senators were generally split this week in how they viewed Trump’s initial executive order, between shrugs from Republicans and frustration from Democrats.
Sen. Chuck Grassley told NOTUS he has long had doubts about Biden’s 2022 policy that Trump revoked.
“I think it’s questionable whether Biden did the right thing and the legal thing. And until I get that answered, I can’t comment on whether Trump was right or wrong,” he said.
But Sen. Ed Markey could comment, bemoaning Trump surrounding himself with some of the richest people in the world during his inauguration.
“But on the same day, Trump signed an executive order which actually is going to result in higher prescription drug prices for Americans,” he told NOTUS. “And prescription drugs are something where Americans really need protections against being gouged.”
A few senators, including Sens. Tommy Tuberville and James Lankford, told NOTUS they hadn’t had a chance yet to review all of the executive orders Trump signed in a flurry of action during his first night in office.
“Truthfully, there have been so many of them I haven’t had a chance to focus very much on that,” Tuberville told NOTUS when asked about Trump’s rescission of the Medicare drug pricing initiatives.
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Margaret Manto is a NOTUS reporter and Allbritton Journalism Institute fellow. Mark Alfred contributed reporting.