What Eli Lilly Thinks of Trumps Plan + Calley Means Promises Cheaper GLP-1's

In case you have missed our 194 updates this week, we are living through one of the wildest and most revealing weeks in drug pricing history.

Let’s start with Eli Lilly. At the Bank of America Healthcare Conference today, CFO Lucas Montarce responded to President Trump’s Executive Order on drug pricing, Most Favored Nation, the EO that ties U.S. prices to what other developed countries pay, also known as Most Favored Nation pricing.

And how did Lilly describe it?

They called it “a stick.”

Not a reform. Not a challenge. Not even a policy. A stick. As in, the government is now waving a large object in their direction and saying, lower your prices or else.

You almost have to respect the honesty.

Lilly made it clear they are not thrilled with the MFN model. They don’t like the idea of comparing U.S. prices to global benchmarks. They think the real issue inside the U.S. system is the rebate spreads, the PBMs, and the mess that turns a drug priced at $1,000 into a $400 pharma payout, only for the patient to still get billed seven hundred (or as the industry calls it, “gross to net pricing”).

But what they did not say was just as loud.

They did not reject the Executive Order. They did not call it unworkable. And they definitely did not walk away. Instead, they highlighted programs like LillyDirect as evidence that they are already doing what the EO is trying to force, direct to consumer options, simpler pricing, and a pathway that bypasses the broken middle layers.

They are not dodging the stick. They are adjusting to it.

Which brings us to the second plot twist.

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Calley Means accidentally makes the case for GLP-1s

In a quote shared by RFK Jr. adviser Calley Means, yes, that Calley Means, we got a glimpse of how even GLP-1 critics are starting to see the writing on the wall.

Speaking about the Trump Executive Order on the topic of GLP-1 drugs, Calley said this:

“To charge $1,300, the U.S. government and patients have a moral right… to not be charged multiples more than other countries… We should not be paying more than other industrialized nations for the same drug”

Yes. Correct. Fully agree.

Twilight zone

This is the same Calley Means who has spent months calling GLP-1s a scam, criticizing the pharmaceutical industry for pushing what he sees as unnecessary interventions, and promoting lifestyle-only fixes while ignoring the reality of metabolic disease at scale.

He also happens to be the brother of Dr. Casey Means, who RFK Jr. has nominated as Surgeon General.

So the irony here is rich. A guy who has publicly attacked the use of GLP-1s is now praising a policy that, if implemented and codified, would do more to expand access to obesity and diabetes medications than any piece of legislation in decades.

Whether he meant to or not, Calley just said the quiet part out loud.

If Most Favored Nation pricing becomes law, and there is now a bill in Congress to make that happen, the ripple effect could be massive. It could set a new floor for direct to consumer programs. It could weaken the PBM stronghold. And it could, finally, make GLP-1 access a reality for people who need it most.

So yes, this week Lilly got the stick. And yes, one of the loudest critics of obesity medicine just endorsed a policy that might unlock it for the masses.

Strange times. But I will take progress wherever I can get it.

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