Early in November, the White House brought drug-company chiefs into the East Room, and President Donald Trump—never one for euphemism—talked about cutting the cost of what he called the “so-called fat drug.” Just two weeks later, his administration said Medicare had secured lower prices on several costly medicines—including $274 for Ozempic and Wegovy—with savings touted in the billions. But there is a twist beneath Trump's triumphalism—the power to make the cuts comes from the Inflation Reduction Act (IRA) of 2022, which was passed by Democrats and signed into law by then President Joe Biden. One number explains why semaglutide (the medication used in the drugs) has become the third rail of health-policy math: Ozempic alone accounted for 2 percent of all Medicare Part D spending in 20

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