Price Drop for Obesity Medications, but Access Remains Limited
Prices for popular obesity drugs Wegovy and Zepbound are decreasing, yet access for many patients continues to be a hurdle. For those uninsured, these medications can cost about $500 per month—an unaffordable price for many individuals. Even for those with insurance, coverage can be inconsistent, leaving patients struggling to pay their bills.
“The question is whether people can afford these medications now that prices are lower,” said Matt Maciejewski, a professor at Duke University who studies obesity treatment. While some doctors are finding inventive ways to treat patients, there is cautious optimism that prices may continue to decline.
Continued High Demand for the Medications
Wegovy and Zepbound belong to a class of medications known as GLP-1 receptor agonists, which have gained significant popularity. In the first quarter of the year, Zepbound made $2.3 billion in sales, ranking it among the top products from Eli Lilly. Wegovy has around 200,000 weekly prescriptions in the U.S., generating nearly $1.9 billion during the same period.
Improved Insurance Coverage for Some
According to the consultant Mercer, more companies with over 500 employees are adding coverage for these injected drugs for their staff and families. Additionally, Novo Nordisk reports that most patients with coverage pay $25 or less monthly. Those with diabetes may also access GLP-1 drugs like Ozempic and Mounjaro, which are approved for their condition.
However, it’s important to note that many state and federally funded Medicaid programs do not cover these medications for obesity, nor does Medicare, which primarily serves older adults. Even when insurance plans do cover these drugs, they often only handle part of the costs, leaving patients with hefty bills, as noted by Dr. Beverly Tchang, a New York doctor.
Inconsistent Coverage Persisting
Employers are concerned about the long-term usage of these medications, leading some large companies to withdraw coverage due to costs. Pharmacy benefit managers (PBMs) are also favoring one brand over another while negotiating agreements with drug manufacturers. Recently, one major PBM has stopped covering Zepbound, prompting some doctors to seek alternative treatment options for their patients.
For instance, Dr. Courtney Younglove’s office provides a video guide to help potential patients check their insurance coverage beforehand. Unfortunately, many end up canceling their appointments once they discover they lack coverage.
Compounded Drugs Still Available
During a shortage, compounding pharmacies began creating cheaper, off-brand versions of Wegovy and Zepbound. Although the FDA has ruled that the shortage has ended, some compounding is still allowed for personalized patient needs. Companies like Hims & Hers Health are offering customized doses of the drug at around $165 a month, but this remains a controversial topic, as Eli Lilly has initiated legal action against such pharmacies.
Decreasing Prices
Both drug manufacturers are currently selling these medications for around $500 a month, which is a few hundred dollars less than earlier prices. However, this amount still represents about 14% of the average U.S. income per person, which hovers around $43,000.
There is potential for further price decline, especially as both companies are working on pill versions of their treatments, expected to be available soon. Some patients have been able to save around 15% by sourcing their doses from Canadian pharmacies.
Overall, experts believe that increased competition and new forms of the drugs could lead to a drop in prices, fostering optimism for the future.
