Transforming US drug access and production: MFN pricing deals and historic manufacturing investments

In November 2025, US President Donald Trump announced transformative actions to lower prescription drug costs and secure the pharmaceutical supply chain in the US. Building on Most Favored Nation (MFN) pricing agreements, the Trump Administration unveiled landmark deals with Eli Lilly and Novo Nordisk that dramatically reduced prices for the companies’ essential diabetes and obesity medicines while mandating their historic investment in US-based pharmaceutical manufacturing. These integrated efforts represent a coordinated strategy to ensure that the nation’s most critical therapies are both manufactured in the US and available at significantly reduced prices in the US market. The announcement focused on the new agreements with Eli Lilly and Novo Nordisk that simultaneously drove down drug prices and committed the companies to major expansions of their US-based production. Through the federal TrumpRx direct-to-consumer platform, the administration secured steep MFN-based discounts on glucagon-like peptide-1 (GLP-1) therapies and other major diabetes and obesity drugs, reducing the prices for Novo Nordisk’s Ozempic (semaglutide) and Wegovy (semaglutide), as well as other similar high-expenditure medicines, by more than two-thirds. Eli Lilly and Novo Nordisk must maintain these discounts and apply similar future pricing across their pipelines as they scale up US manufacturing. Under the agreements, the cost of Ozempic and Wegovy will fall from $1,000 and $1,350 per month, respectively, to $350 per month. Once approved, Eli Lilly’s Zepbound (tirzepatide) and orforglipron will be available at $346 per month. Potential oral GLP-1 drugs, pending Food and Drug Administration approval, will launch at $150 per month. These pricing reforms expand access and enable Medicare and Medicaid to cover antiobesity medications for the first time, with Medicare capping patient copays at $50. The Trump Administration emphasised the urgent need for accessible obesity treatments, as 40% of US adults are obese, which is a driving factor behind the increase in type 2 diabetes, cardiovascular disease, hypertension, stroke, and other chronic conditions. Making innovative drugs more affordable through MFN pricing and expanded Medicare coverage is a pivotal step in the fight against obesity. Sustaining these price reductions is only possible through a decisive move away from a dependence on imported medicines and towards robust, large-scale domestic manufacturing. Eli Lilly has announced at least $27bn in new US manufacturing investments as part of a broader post-2020 expansion exceeding $50bn, constituting the largest pharmaceutical manufacturing buildout in US history. Three of Eli Lilly’s four new facilities will produce active pharmaceutical ingredients such as tirzepatide, which is used in its Zepbound and Mounjaro, while the fourth facility will focus on injectable medicines, anchoring GLP-1 and biologic supply chains within the US. Novo Nordisk has committed an additional $10bn to strengthen its footprint in the US, including domestic, end-to-end production of a potential Wegovy tablet. The company’s expanded North Carolina facilities are already supporting oral semaglutide manufacturing, reflecting the administration’s push to rebuild US capacity and shield patients from the supply disruptions experienced during recent shortages. Together, these commitments support the shift towards making the US both a manufacturing hub and the global price-setting market for advanced metabolic therapies. In a separate but related initiative, the Trump Administration announced a sweeping agreement with EMD Serono to reduce the cost of in vitro fertilisation (IVF). The deal delivers a 42-79% reduction in drug costs for a typical IVF cycle and will bring the company’s full fertility portfolio onto TrumpRx starting in 2026. In exchange, EMD Serono secured an exemption from upcoming US pharmaceutical tariffs, conditional on an expansion of its domestic manufacturing and a research investment. This mirrors the administration’s broader strategy of tying pricing concessions to concrete commitments that strengthen the US’ pharmaceutical industrial base. GlobalData Strategic Intelligence Don’t let policy changes catch you off guard. Stay proactive with real-time data and expert analysis. By GlobalData Taken together, the MFN pricing agreements and associated manufacturing pledges represent a fundamental shift in how the US approaches both drug affordability and pharmaceutical production. The strategy moves beyond price regulations to a deliberate industrial transformation that positions the US as both the anchor customer and primary manufacturing platform for next-generation therapies, especially GLP-1 and IVF medicines. The Trump MFN initiative reframes the conversation from short-term price controls to long-term national health and industrial revitalisation, ensuring that affordable, innovative medicines are produced first and foremost within the US.