GLP-1 costs have skyrocketed

Over the last few years, GLP-1 weight-loss drugs have become more widespread, leading to a significant increase in spending on these drugs.

According to a new study published in the Annals of Internal Medicine, the number of U.S. adults without diabetes using GLP-1 drugs more than tripled between 2018 to 2022, growing from an annual prevalence of 0.1% to 0.4%. Annual spending on the drugs also increased from $1.6 billion to $5.8 billion during the same time.

These patients filled an average of 4.1 GLP-1 prescriptions per year, spending an average of $1,540 per prescription. However, since almost 86% of these patients had private insurance, their out-of-pocket costs for GLP-1 drugs were relatively small at $35 per prescription or $144 per year.

In a separate report from Evernorth, researchers found that pharmaceutical spending has grown significantly since GLP-1 drugs were approved for chronic weight management in 2021. Between 2021 and 2024, the annual growth rate for semaglutide increased from 2.1% to 12.8%.

In 2024, GLP-1 drugs accounted for 6.7% of total drug costs and 46.8% of the total increase in drug spending. In addition, GLP-1 drugs for weight loss saw an 210.2% increase in spending in 2023 and a 148.7% increase in 2024.

"Looking ahead, GLP-1 therapies will continue expanding beyond obesity and diabetes treatment to other chronic conditions, accelerating their widespread adoption," the researchers wrote. "While these advancements offer transformative potential in addressing the chronic disease epidemic, they also bring significant challenges raising critical questions about affordability, accessibility and long-term sustainability."

However, Howden added that CMS has not ruled out covering GLP-1 drugs for weight loss and "may consider future policy options" for the drugs.

According to Courtney Breen, an analyst at Bernstein, the Trump administration dropping the proposal was "not surprising," especially since "pharmaceutical tariffs [are] under negotiation, [and] this is not the time for the administration to give without getting."

In response to the decision, Eli Lilly, which manufactures the GLP-1 drug Zepbound, said that it was disappointed but would "continue to work with the Trump Administration and Congressional leaders to ensure people living with obesity are covered by Medicare and Medicaid and are no longer left behind."

Separately, Novo Nordisk, which manufactures the GLP-1 drug Wegovy, said it hopes the Trump administration will soon finalize the definition of obesity since "[i]t is essential that CMS regulations are aligned with current medical science — and that means recognizing obesity as a serious chronic disease."

"We're just back to the status quo, which is people on Medicare who need these drugs or want these drugs need to pay for them out of pocket," said Juliette Cubanski, deputy director of KFF's Program on Medicare Policy. "And given the high cost, that may be, for many people with Medicare, prohibitive in terms of access."