Prescription fills for blockbuster weight loss drugs in the U.S. have more than doubled in 2024, despite limited insurance coverage and high out-of-pocket costs, according to new data from drug savings company GoodRx. This surge in demand highlights the immense interest in a class of medications called GLP-1 and GIP agonists,which mimic gut hormones to suppress appetite and regulate blood sugar.
Thes medications include Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound, both of which carry hefty list prices of roughly $1,000 per month before insurance or savings cards. Despite the cost, prescription fills for Wegovy and Zepbound have increased by more than 100% and 300%, respectively, since the beginning of 2024. Zepbound’s impressive jump reflects its first year on the market, having received U.S. approval in November 2023. Wegovy, conversely, was approved in 2021.
“It’s just a pretty astronomical increase in sales, and because of that, a lot of eyes are on them around their affordability and accessibility,” said Tori Marsh, director of research at GoodRx, in an interview.
The data comes from GoodRx’s new weight Loss Medications Tracker, which analyzes fill trends and spending patterns in the U.S. for popular weight loss medications. Notably, only 9% of people with commercial insurance have unrestricted coverage for Zepbound, and 14% have unrestricted coverage for Wegovy, according to GoodRx.
This surge in demand for weight loss drugs, despite their high cost and limited insurance coverage, underscores the growing need for effective weight management solutions and raises vital questions about access and affordability in the healthcare system.
Access to weight loss medications in the United States remains a important challenge for many Americans, despite the growing recognition of obesity as a chronic disease. While some insurance plans offer coverage for these treatments, a significant portion of patients face restrictive policies or high out-of-pocket costs.
According to GoodRx, a platform that tracks prescription drug prices, approximately 30% to 40% of insured individuals have insurance plans that provide straightforward coverage for weight loss drugs. “That refers to insurance coverage without any additional hoops for patients to jump through, such as prior authorization or higher BMI requirements,” explained Tori Marsh, a GoodRx spokesperson.
However, a significantly larger percentage of patients, around 60% to 70%, are enrolled in plans with more restrictive coverage. Even with insurance, out-of-pocket expenses can be substantial. Marsh noted that the average insured person taking Zepbound, a popular weight loss medication, can expect to pay over $2,500 annually in copays. GoodRx data indicates that individuals spent an average of $231 out of pocket each month for a Zepbound prescription between January 2023 and October 2023.
“Insurance is just not the stopgap that it used to be,”
said Marsh, highlighting the increasing financial burden placed on patients seeking weight loss treatment.
Alarmingly, nearly one in five individuals with commercial insurance lack coverage for at least one branded GLP-1 and GIP agonist prescribed for weight loss. GoodRx estimates that Americans have overspent by at least $200 million by paying full retail prices for these medications instead of utilizing savings options like GoodRx coupons or assistance programs offered by pharmaceutical companies like Eli Lilly and Novo Nordisk.
GoodRx reports that uninsured individuals can save an average of $250 per month, or $3,000 annually, by using their coupons for weight loss drugs. This data aligns with other research indicating inconsistent insurance coverage for weight loss medications in the U.S. A survey published in October revealed that less than 20% of large employers in the country include coverage for these treatments in their health insurance plans.
Federal Medicare also does not cover weight loss treatments unless they are approved and prescribed for another health condition. Research suggests that covering these drugs could significantly increase costs for employers and government programs.
However, a glimmer of hope emerged in November when the Biden administration proposed a rule that would allow Medicare and Medicaid to cover weight loss drugs for patients with obesity. If approved by the incoming administration, this rule could significantly expand access to these potentially life-changing treatments.
## Q&A with Tori Marsh on the Surging demand for Weight Loss Drugs
**World-Today News**: Tori, thank you for joining us today. GoodRx’s new data shows a significant increase in prescriptions for weight loss drugs like Wegovy and Zepbound.Can you tell us more about these findings?
**Tori Marsh**: Absolutely.Our Weight loss medications Tracker reveals a remarkable surge in demand for GLP-1 and GIP agonists,which include popular drugs like Wegovy and Zepbound. We’re seeing prescription fills more than double for these medications in 2024 alone,despite significant cost barriers.
**World-Today News**: That’s interesting considering the hefty price tag these drugs carry. How are people affording them?
**Tori Marsh**: That’s the million-dollar question, literally! The list prices for these medications are undeniably high, around $1,000 per month before insurance or savings programs kick in. While some insurance plans offer coverage, many individuals face high out-of-pocket costs, leaving many patients struggling to afford these possibly life-changing treatments.
**World-Today News**: Zepbound, being newer to the market, saw a particularly striking increase in prescriptions. What do you make of that?
**Tori Marsh**: It’s certainly noteworthy. Zepbound’s remarkable 300% increase in prescriptions since its approval in November 2023 speaks volumes about the pent-up demand for effective weight management solutions.
**World-Today News**: The data shows a stark contrast between the demand for these medications and the limited insurance coverage for them. What are the implications of this gap?
**Tori Marsh**: This disparity exposes a critical issue regarding access and affordability in our healthcare system. While these medications offer immense potential for individuals struggling with obesity, many are priced out of treatment.
**World-Today News**: Do you foresee this trend of increasing demand continuing?
**Tori Marsh**: It’s likely. The growing recognition of obesity as a chronic disease, coupled with the effectiveness of these medications, will likely sustain this demand. However, the lack of accessibility for many americans remains a major concern. We need to find solutions that ensure equitable access to these potentially life-changing treatments.
**World-Today News**: Tori,thank you for shedding light on this significant issue.
