“I’m in London, and I just paid for this damn fat drug I take. I said, it’s not working. They said, he said, I just paid $88 and in New York I paid $1,300. What the hell is going on?”
Earlier this year, a friend of President Donald Trump shared these remarks during a phone call. Trump recounted the story at the White House during a briefing on a new pricing model for prescription drugs.
Go deeper with GlobalData
“So, I checked, and it’s the same box made in the same plant by the same company. It’s the identical pill that I buy in New York, and here I’m paying $88 in London, in New York, I’m paying $1,300,” Trump said whilst recounting the story.
The pricing reforms, which use the “most favoured nation” pricing model, will affect branded prescription drugs. But Trump called out “fat drugs” specifically, primarily due to their unprecedented rate of uptake in the US.
Price differences are especially pertinent with these weight loss drugs, which are officially called glucagon-like peptide-1 receptor agonists (GLP-1RA), due to the emergence of compounded alternatives in the past few years. These personalised weight loss medicines, which are chemically identical to branded alternatives, are significantly cheaper.
Pharmaceutical Technology looks at the spectrum of GLP-1RA price points, including how compounded alternatives are impacting big pharma’s weight loss drugs, along with consequences to patient access.
US Tariffs are shifting - will you react or anticipate?
Don’t let policy changes catch you off guard. Stay proactive with real-time data and expert analysis.
By GlobalDataA spectrum of complex price points
Trump’s friend is, largely, correct, though the exact numbers are a little off when comparing the same doses. Weight loss drugs, commonly known under the brand names Wegovy (semaglutide) and Mounjaro (tirzepatide), developed by Novo Nordisk and Eli Lilly, respectively, are indeed more expensive in the US than the UK. The list price for a month’s supply of 2.4mg Wegovy – the drug’s highest dose – is $1,350 in the US, whereas the same dose in the UK costs £175.80 each month.
Helena, who is 39 and was on Wegovy in the UK, told Pharmaceutical Technology that even $1000 is “completely out of reach”. She says that her subscription model – which is £150 a month in the UK – already “feels quite expensive.”
Helena acquired her weight loss drugs via a subscription plan with an online pharmacy in the UK, which offers products at a slightly lower cost. A month-by-month service, she says, allows flexibility compared to long-term commitment when she’s unsure how her body might respond. Helena is one of thousands of patients being prescribed Wegovy without even directly speaking to a doctor, answering just a basic questionnaire.
These telehealth approaches have bloomed in the GLP-1RA era, with patients seeking accessible routes to the medication that are often associated with significantly lower costs.
“I don’t understand why medication costs are so much higher in the US compared to Europe, though I’ve noticed prices can vary across European countries too,” said Helena.
“It feels like in the US, pharmaceutical companies are capitalising on people’s frustration and desperation to lose weight.”
Unintended compounded price point
Compounded drugs are custom-made and unbranded medications that contain the same active ingredient as a marketed drug, such as semaglutide or tirzepatide via a prescription. Pharmacies have long dispensed compounded medication to individual patients under a prescription. 503As are traditional retail pharmacies that compound medications and focus on patient-specific prescriptions while 503Bs are outsourcing facilities that can distribute larger batches. Several telehealth companies partner with 503Bs to carry out their business model.
A shortage of a commercially available drug is one of the criteria that allows compounded production, according to FDA legislation. Telehealth platforms selling compounded GLP-1RAs flourished in 2023 and 2024 amid shortages of semaglutide and later tirzepatide.
The compounded drug industry exists to fill gaps in medication supply, along with offering personalised therapy with commercially unavailable doses. An unintended consequence in the GLP-1RA sector has been their lower price point – an aspect that some telehealth companies have sought to exploit.
Hims & Hers Health, an online telehealth platform that gained notable attention courtesy of its advertisement aired during the 2025 Super Bowl, offers compounded GLP-1RA injections for $199 a month.
Mochi Health, also a telehealth platform, offers a wellness membership for $49 per month, with an additional $99 for a month’s supply of compounded GLP-1. Mochi Health recently announced insurance-based plans, new offerings that are an optional upgrade to existing plans.
Novo Nordisk and Eli Lilly have not been pleased with the compounding sector’s erosion of their market share. There is no precise data on Eli Lilly and Novo Nordisk’s market share compared to telehealth companies. However, Eli Lilly has outpaced its rival based on GLP-1 revenue. Eli Lilly’s Mounjaro generated 2024 sales of $11.5bn, whilst Novo’s Wegovy brought in approximately $8bn.
Mochi Health is even the subject of a lawsuit initiated by Eli Lilly. Novo Nordisk took a different route with Hims & Hers – the drugmaker partnered with the telehealth company to offer Wegovy via a bundled membership package in April 2025. However, just two months later, the big pharma company ended the collaboration, saying that the Hims & Hers “has failed to adhere to the law, which prohibits mass sales of compounded drugs under the false guise of ‘personalisation’ and are disseminating deceptive marketing that puts patient safety at risk.”
Mochi Health’s CEO Myra Ahmad told Pharmaceutical Technology that her company is still open to partnerships, provided autonomy on dosing is not curbed, though potential changes to price were not discussed.
“[Partnerships] are something we are open to exploring. My biggest thing with any partnership that we’re pursuing is that we need to let our providers have full autonomy over what they’re prescribing to whom. We do combinations of medications. We let providers taper patients up and then taper back down. So, anything that takes that physician autonomy away is not something that we want to partner with,” Ahmad said.
Both Novo Nordisk and Eli Lilly have also launched their own direct-to-consumer pharmacies, offering discounted versions of their flagship drugs to provide competition to compounding pharmacies.
Compounded GLP-1RA drugs have their use for certain patients. However, their lower price point is an unintended consequence and should not be a deciding factor for doctors issuing prescriptions.
Alliance for Pharmacy Compounding CEO Scott Bruner said: “What we’re also hearing is that a lot of patients are experiencing ‘sticker shock’ at the pharmacy counter when they see the difference in the price between the compounded drug and the FDA-approved drug.
“It bears repeating – the price of a compounded drug is not a legitimate reason for dispensing, and yet we can’t avoid the discussion of price right now.”
“No news is good news”
Matters have been complicated by recent FDA legislation that requires compounders to stop producing versions of semaglutide and tirzepatide as both drugs are no longer in shortage. Some companies such as Hims & Hers and Mochi Health, have skirted around this by maintaining they will offer personalised therapy.
The sheer volume of patients currently taking compounded GLP-1RAs signals uncertain times for the sector’s future. Sticker shock will be an ongoing problem for many soon, who originally turned to compounded weight loss drugs, enticed by the cheaper costs.
Indeed, some began stockpiling their medication when the FDA announced its deadlines for compounding cessation. Weight loss forums on the social media website Reddit are abundant with patients detailing how they are hoarding vials of compounded semaglutide. Meanwhile, others have maintained status quo despite being kept in the dark about the future of their access.
“I’m still getting mine though ReviveRX. I have not heard there will be any issues,” said one user to Pharmaceutical Technology.
“I go through a telehealth clinic that presumably can switch to another pharmacy if needed. I haven’t heard anything from them or the telehealth clinic. I assume no news is good news.”
Ahmad is confident that patients need not worry, telling Pharmaceutical Technology: “The message is that [compounded GLP-1RAs] are here to stay, you will consistently have access. Stockpiling is not necessary. And for medications, there’s an expiration date, and so it’s often just going to lead to a lot of waste.
“We’re here to work with patients on making sure that they have access to whatever medication plan their provider has put out for them.”
Trump’s price push
Weight loss medication is just the tip of the iceberg when it comes to prescription drug prices in the US.
“Today, the US pays, on average, three to four times higher prices than other developed countries around the world for the same branded drugs,” says Professor Mariana Socal from the Johns Hopkins Bloomberg School of Public Health.
Speaking during a media briefing on Trump’s economic shakeup to the pharmaceutical supply chain in the US, Socal says the price differences mean many Americans are not able to afford the drug that they need due to cost. She adds that patients often skip doses, take a lower dose than prescribed, or do not fill a prescription altogether because they cannot afford it.
As Trump’s friend himself put it, this is encapsulated in the world of GLP-1RA medication. It also goes some way to explaining the sheer volume of patients turning to compounded GLP-1RAs for weight loss.
Trump’s ‘most favoured nation’ model comes at a time when the administration has been vocal on its support for generics and biosimilars – copycat drugs that offer patients a cheaper entry point to treatment.
It remains to be seen if the pricing of compounded GLP-1RAs remains stable going forward, and indeed if the FDA will allow telehealth companies to continue offering the medication under personalised therapies.
Ultimately, the market will be swayed by patient demand, which can easily change.
“Ironically, I’ve ended up losing more weight on my own than I ever did while using Wegovy,” muses Ex-Wegovy user Helena.
“So even if I were in the US, I’d likely make the same decision to stop paying and stop using it.”
