I suspect a big reason for why Mounjaro is still fairly expensive here in Germany (I pay nearly €400 for a 10mg Qwickpen - a 12.5mg Qwickpen is nearly €500) is due to health insurance not being allowed to cover them for anything but diabetes treatment.

If health insurance companies would be able to cover these drugs, there'd have to be negotiations between Eli Lilly and the insurance companies, and insurance companies have a bigger lever than individual patients who pay out of pocket. Self-payers are just price-takers. We pay whatever Eli Lilly wants us to pay.