Britons face price hikes for a leading anti-obesity drug after Donald Trump signalled he wants consumers in Europe and beyond to pay more for American-made medicines, experts have warned.
The President’s “America First” policy could see him lower prices at home by charging other countries more for these game-changing drugs.
Mounjaro, also known as Zepbound and dubbed the “King Kong of weight-loss jabs”, costs more than £100 on the NHS but in the US, where its maker Eli Lilly is headquartered, the retail price rockets up to nearly £900.
Unlike in most European countries, including the UK, where medicine costs are heavily regulated, the US imposes no such price controls, resulting in Americans paying about three times more than elsewhere. In the case of slimming jabs, American users can pay as much as 10 times the price paid by European health systems such as the NHS.
The head of Indiana-based Eli Lilly has suggested that drug pricing is being sized up by Trump as a tool for extracting higher revenues from competitor countries in return for reducing the medicine bills of ordinary Americans. While the burden to the NHS might be limited due to the way contracts are negotiated, private suppliers could be more vulnerable to price rises.
Eli Lilly boss David Ricks, whose company is set to make $27bn (£21.7bn) a year from Mounjaro/Zepbound sales by the end of the decade, revealed the Republican president had made clear that ending drug cost disparities would be a priority for the White House during a private dinner with Big Pharma bosses at Mar-a-Lago – Trump’s resort in Florida.
“We have to raise developed countries, what they pay, and we can lower the US,” Ricks said recently at the Economic Club of Washington. “I think that’s a policy argument we’ll hear about soon with the new administration.”
According to data provided by health data company Airfinity, Mounjaro costs £108 per dose on the NHS (rising to about £170 for a private prescription), compared to a list price $1,069 (£859) in America. Wegovy costs in the UK range from up to £240 for a private prescription and an NHS cost of £99, compared to a list price of $1,349 (£1,085) in the States.
Redressing what he perceives as unfair trade balances is a cornerstone of the Trump administration’s strategy. He has already shown he is ready to use swingeing tariffs as a lever against countries ranging from China to Colombia to achieve his policy goals.
Pharmaceuticals sector experts and industry sources told The i Paper that while the mechanism and timetable for achieving such price adjustments for weight-loss jabs was unclear, patients and consumers in the UK could find themselves being asked to pay more for American-made medications, including Mounjaro or Zepbound.
While availability of Mounjaro is limited on the NHS, demand for anti-obesity jabs via private prescriptions and online pharmacies is booming, with hundreds of thousands of Britons estimated to be buying the products on a monthly basis. The National Pharmacy Association, which represents independent chemists, has called for tougher regulation of online weight-loss jab sales amid concerns that patients are obtaining the products without sufficient consultation or access to medical records.
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Alongside Ozempic and Wegovy, the anti-diabetes and weight-loss jabs made by Danish company Novo Nordisk, Mounjaro and Zepbound are currently the only two major players in a global market for anti-obesity medications which is currently worth about £4.8bn a year and could be worth as much as £80bn per annum by the end of the decade. In its first nine months of global availability last year, Zepbound, which results in weight loss of about 20 per cent over 17 months compared to 14 per cent for Wegovy, racked up sales of £2.4bn.
Cyrus Fan, a health economics research analyst at GlobalData, a London-based consultancy, pointed out that during his first term Trump had unsuccessfully sought to achieve higher drug prices beyond the US as means to slash costs at home and it would “not be surprising” if he returned to the issue – with Britons consequently facing increased prices for weight-loss jabs as well as other medications.
Fan said: “Trump is seeking to lower drug prices in the US but what he will do to achieve this is not yet known… We could see an increase in price for Mounjaro/Zepbound in the UK but it is hard to determine how significant an increase this would be. It would also be likely other pharma manufacturers will follow suit if companies like Lilly increase the price of their products.”
‘Fair’ for other countries
Eli Lilly told The i Paper it was happy to engage with the Trump administration, whose health secretary Robert Kennedy is an avowed vaccine sceptic who has previously voiced his opposition to so-called Big Pharma, over reducing drug prices in its domestic market.
However the company – which has seen its share prices increase by 700 per cent in the last five year but has more recently hit turbulence over disappointing sales figures – said it was also committed to offering its products at “fair prices” in countries such as the UK.
A spokesperson said: “Lilly welcomes a policy discussion with the new administration, focused on how we can lower the cost of medicines for Americans. At the same time, we will continue to follow local regulations for price setting so that citizens in other advanced economies can access medicines at fair prices.”
The US Department of Health and Human Services did not respond to a request to comment.
The future of weight-loss
Despite its recent travails, Eli Lilly looks increasingly comfortable in its battle for an enduringly dominant share of the global anti-obesity market.
The drug giant has several potential blockbuster innovations in the pipeline, including orforglipron – the world’s first anti-obesity pill.
And retatrutide has shown in trials higher levels of weight loss than Mounjaro/Zepbound with additional benefits for heart and liver health.
Despite longstanding criticism from European officials that the US should impose its own cost-effectiveness rules if it wants to lessen the financial burden on its citizens, the argument that American consumers are in effect subsidising the development of cutting-edge drugs made by US companies for patients in Europe and elsewhere appears to be gaining currency in Washington.
Ed Schoonveld, a former pricing executive at Eli Lilly and principal advisor at Schoonveld Advisory, a business consulting firm, told the Wall Street Journal: “To some extent, European consumers are free-riding on the willingness of American society to give new drugs a chance.”
Market share battle
The path to redressing any imbalance nonetheless remains difficult. Eli Lilly, which has pointed to research suggesting Mounjaro/Zepbound results in a higher rate of weight loss than Wegovy, is locked in a ferocious battle for market share around the world not only with Novo Nordisk but also with other pharma giants racing to secure a share of what is widely regarded as the biggest medicine gold rush for a century.
One executive with a European drug company said: “Whether it’s defence or medicines, the Trump administration is hooked on the idea that America and Americans get ripped off by Europeans. When it comes to pharma, I don’t think it’s true but, yes, price rises could be coming. The point for companies like Eli Lilly though is that they probably can’t afford to be 20 or 30 per cent more expensive than their competitor. So if there are price rises, they are likely to be modest.”
Experts pointed out that the NHS, which negotiates drug prices under multi-year contracts and currently only provides anti-obesity jabs such as Wegovy and Mounjaro/Zepbound in limited circumstances via over-subscribed weight-loss clinics, would be largely insulated from price competition.
Simon Wells, lead analyst for metabolic diseases at Airfinity, said: “The UK’s healthcare system negotiates confidential pricing agreements with pharmaceutical companies, often securing discounted rates that align with strict cost-effectiveness thresholds. As such, it is unlikely that there would be a sudden increase in the NHS price of a drug like Mounjaro/Zepbound that would jeopardise its cost-effectiveness.”
The UK Department of Health and Social Care has been contacted for comment.
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