A mix image shows an injection pen of Zepbound, Eli Lilly’s weight reduction drug, and boxes of Wegovy, made by Novo Nordisk.
Reuters
Prescription fills for blockbuster weight reduction drugs within the U.S. greater than doubled in 2024, even with limited insurance coverage and high out-of-pocket costs for the treatments, in accordance with data released Thursday by drug savings company GoodRx.
The figures offer more evidence of the insatiable demand for a buzzy class of medicines called GLP-1 and GIP agonists, which mimic gut hormones to suppress appetite and regulate blood sugar. That features Novo Nordisk‘s weight reduction drug Wegovy and Eli Lilly‘s obesity treatment Zepbound, which have hefty list prices of roughly $1,000 per thirty days before insurance or savings cards.
Prescription fills for Wegovy and Zepbound increased by greater than 100% and 300%, respectively, for the reason that start of 2024. Zepbound’s jump reflects its first 12 months available on the market, because it was approved within the U.S. in November 2023. Wegovy won U.S. approval in 2021.
“It’s just a fairly astronomical increase in sales, and since of that, quite a lot of eyes are on them around their affordability and accessibility,” GoodRx director of research Tori Marsh said in an interview.
The info comes from GoodRx’s latest Weight Loss Medications Tracker, which examines fill trends and spending patterns within the U.S. for popular weight reduction medications.
The high fill rates come at the same time as just 9% of individuals with industrial insurance have unrestricted coverage of Zepbound, and 14% have unrestricted coverage of Wegovy, in accordance with GoodRx. That refers to insurance coverage with none additional hoops for patients to leap through, corresponding to prior authorization or higher BMI requirements.
Far higher rates of patients — around 60% to 70% — are under insurance coverage with more restrictive coverage of the drugs. But Marsh said out-of-pocket costs can add up, even when a patient has insurance coverage for a weight reduction treatment.
The typical insured person taking Zepbound can expect to pay over $2,500 a 12 months in copays for the drug, she said. GoodRx found that individuals spent $231 on average out of pocket for a monthly prescription of Zepbound from January 2023 to October this 12 months.
“Insurance is just not the stopgap that it was once,” Marsh said.
Meanwhile, nearly 1 in 5 individuals with industrial insurance haven’t any coverage of not less than one branded GLP-1 and GIP agonist prescribed for weight reduction.
GoodRx found that Americans have overspent by not less than $200 million by paying the complete retail prices for weight reduction medications as a substitute of leveraging savings options, corresponding to GoodRx’s coupons or assistance programs offered by Eli Lilly or Novo Nordisk. GoodRx said it calculated the overpayment number based on the typical price people could have paid for a drug with a GoodRx discount.
GoodRx said people without insurance can save a mean of $250 monthly, or $3,000 annually, using its coupons for weight reduction drugs.
GoodRx’s data is consistent with other research indicating spotty insurance for weight reduction drugs within the U.S. For instance, a survey published in October found that lower than a fifth of huge employers within the country include coverage of those treatments of their medical insurance plans.
The federal Medicare plan also doesn’t cover weight reduction treatments unless they’re approved and prescribed for one more health condition. Research has shown that covering the drugs could significantly raise costs for employers and state and federal governments.
However the Biden administration in November proposed a rule that might allow Medicare and Medicaid to cover weight reduction drugs for patients with obesity. If greenlit by the incoming Trump administration, the rule would significantly expand access to the treatments.
