Novo Nordisk, Eli Lilly Weight Loss Price War Heats Up. Why It’s a Worry for the Stocks.

(SERGEI GAPON/AFP via Getty Images)

Key Points

• Novo Nordisk is undercutting Eli Lilly on weight loss drug prices for cash-paying consumers, with Wegovy now costing $349 per month.
• Starter doses of Novo Nordisk’s Wegovy will cost $199 per month through March, while Lilly’s Zepbound starter doses are $299 per month.
• Both companies view direct-to-consumer sales as central to their weight loss market strategies, especially given limited insurance coverage.

A newly aggressive Novo Nordisk is undercutting rival Eli Lilly on the price of its weight loss drugs for cash-paying consumers. Both companies see the direct-to-consumer market as increasingly important to their weight loss drug strategies.

The new prices for patients paying cash for Novo’s Wegovy were telegraphed earlier this month at a White House press conference announcing agreements between the Trump administration, Lilly, and Novo, that cleared the way for Medicare to pay for the weight loss drugs.

Novo announced the pricing details on Monday. As of today, cash-paying patients will pay $349 per month for Wegovy, down from its prior price of $499 per month. Lilly had previously said that most doses of its weight loss drug Zepbound will cost “no more than $449” per month for cash-paying customers.

Novo also said Monday that starter doses of Wegovy will cost $199 per month through the end of March. Starter doses of Lilly’s Zepbound will cost $299 per month under the new pricing announced at the White House.

Signs of a weight loss price war appeared to worry investors early Monday, and Lilly shares were down 1.2% on Monday, while Novo’s American depositary receipt was down 0.6%. The S&P 500 was down 0.2%.

The new price war comes as the weight loss drug manufacturers have grown increasingly open about the centrality of the new direct-to-consumer channels to their weight loss market strategies. As Barron’s wrote earlier this year, drugmakers initially embraced direct-to-consumer sales as a way to address the Trump administration’s concerns on high U.S. list prices while preserving their own profit margins.

Direct-to-consumer drug sales cut out insurers and pharmacy-benefit managers. While the sticker prices are lower than the official list prices of the prescription drugs, patients with insurance that covers the medicines are generally better-served using traditional pharmacy channels.

For the weight loss drugmakers, though, the fascination with direct-to-consumers prescription drug sales has become a major theme. Insurance coverage is limited for weight loss drugs, and the companies see in the direct-to-consumer market a way to get around the limits imposed by managed care.

On a podcast interview with the president and the CEO of the digital payment company Stripe published last week, Lilly CEO David Ricks appeared to suggest that the strength of the direct-to-consumer weight loss business could allow Lilly to grow through future patent expirations.

“There is this belief that perhaps, for those that are really long our stock, this cycle could be different,” Ricks said. “That you create… much more of a self-pay, branded business that has staying power beyond the patent cycle.” Lilly did not respond to a request for elaboration on the point.

Prior to the White House deal announcement, both Lilly and Novo had charged $500 per month to cash-paying customers for most dosages of their weight loss drugs.

For Novo, the apparent effort to compete on price comes amid internal turmoil tied to its continued loss of share in the weight loss market. Novo’s ADR is down 50% over the past year, and more than 40% in 2025. The company has replaced its CEO and, on Friday, replaced its board of directors at an extraordinary general meeting. It also launched an aggressive and ultimately failed attempt to snatch a weight loss biotech from Pfizer , which had signed a deal to acquire the company.

Novo said Monday that patients could pay for Wegovy through the company’s website for pickup at pharmacies across the country, or through telehealth pharmacies including Novo’s in-house NovoCare.

Corrections & Amplifications: Wegovy’s previous price for cash-paying customers was $499 per month. An earlier version of this article incorrectly said that the prior price was $359 per month.

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com