Costs drop, access expands for GLP-1 weight loss drugs

Editor's Note

Access to GLP-1 medications is improving as manufacturers, insurers, and policymakers address high demand, costs, and coverage challenges, Becker’s Hospital Review reported December 13.

As detailed in the article, Eli Lilly’s partnership with telehealth company Ro now allows patients to obtain Zepbound prescriptions online and receive shipments directly through LillyDirect. The drug is available for out-of-pocket costs starting at $399 for a single-dose vial, offering a four-week supply.

The article also covers how regulatory updates have also broadened access. For example, Zepbound’s label no longer includes specific BMI thresholds, focusing instead on individuals with obesity or overweight conditions and related comorbidities. However, insurer and pharmacy benefit manager (PBM) policies will still influence actual accessibility.

Novo Nordisk’s Ozempic could see price reductions under Medicare drug price negotiations, Becker’s reports. Increased competition from Lilly’s discounts and an anticipated influx of over 16 new weight loss drugs by 2029 is expected to lower prices by over 10% annually by 2027.

Additionally, Teva Pharmaceuticals has introduced the first generic version of Victoza, a GLP-1 drug for Type 2 diabetes and cardiovascular risk reduction. Although demand for brand-name drugs remains high, generics are projected to expand access, Becker’s reports.

Cost pressures have prompted some insurers to drop coverage. Meanwhile, “net prices for GLP-1 drugs have dropped for individuals covered by Medicare and commercial insurance,” Becker’s reports. “Medicare Part D still does not cover GLP-1s for obesity alone but allows coverage when the drugs address other approved health conditions, such as cardiovascular disease.”  

Prices for a one-month supply of GLP-1 drugs are roughly $1,000, but “net prices are significantly lower due to payer negotiations,” Becker’s reports. Citing HHS, the article notes that future prices will depend on how many conditions are approved for each drug, Medicare price negotiations, and the development of new drugs.