December 23, 2024

A combined image shows an injection pen for Eli Lilly and Co’s diet drug Zepbound and a box of Wegovy, made by Novo Nordisk.

Reuters

U.S. prescriptions for the blockbuster weight-loss drug more than doubled in 2024 despite limited insurance coverage and higher out-of-pocket costs, data from drug savings company GoodRx showed Thursday.

The numbers provide more evidence of insatiable demand for a popular class of drugs called GLP-1 and GIP agonists, which mimic gut hormones to suppress appetite and regulate blood sugar. This includes Novo NordiskThe weight loss pills Wegovy and Eli Lilly and CompanyThe obesity treatment drug Zepbound comes with a hefty price tag, about $1,000 a month without insurance or a savings card.

Since the beginning of 2024, prescription volumes for Wegovy and Zepbound have increased by more than 100% and 300%, respectively. Zepbound’s growth reflects its first year on the market as it receives approval in the U.S. in November 2023. Get approval.

“There’s been an astronomical increase in sales, and because of that, a lot of people are looking at their affordability and accessibility,” Tori Marsh, director of research at GoodRx, said in an interview.

The data comes from GoodRx’s new Weight Loss Drug Tracker, which examines filling trends and spending patterns for popular weight loss drugs in the United States.

Even though only 9% of the commercially insured population has Zepbound’s unrestricted coverage and 14% has Wegovy’s unrestricted coverage, fill rates are still high, according to GoodRx data. This means coverage without any additional hoops for patients to jump through, such as prior authorization or higher body mass index requirements.

A higher proportion of patients (about 60% to 70%) are enrolled in plans with more restrictive drug coverage. But even if patients have insurance for weight loss treatment, out-of-pocket costs can increase, Marsh said.

She said policyholders taking Zepbound pay an average of more than $2,500 a year in out-of-pocket costs. GoodRx found that from January 2023 to October of this year, people paid an average of $231 out of pocket for a monthly Zepbound prescription.

“Insurance is no longer the stop-gap measure it once was,” Marsh said.

At the same time, nearly one in five people with commercial insurance did not purchase at least one brand-name GLP-1 and GIP agonist for weight loss.

GoodRx found that Americans are already overspending by at least 2% by buying weight-loss drugs at full retail price rather than taking advantage of savings options like GoodRx’s coupons or assistance programs from Eli Lilly or Novo Nordisk. billion dollars. GoodRx says it calculates the overpayment amount based on the average price people can pay under GoodRx discounts.

GoodRx says people without insurance can save an average of $250 per month and $3,000 per year using its diet pill coupons.

GoodRx’s data is consistent with other studies showing that coverage for diet pills is spotty in the United States. publish October found that fewer than one in five large employers nationwide include these treatments in their health insurance plans.

Medicare also does not cover weight loss treatments unless they are approved and prescribed for other health conditions. Research shows that covering these drugs can significantly increase costs for employers as well as state and federal governments.

But the Biden administration proposed a rule in November that would allow Medicare and Medicaid to cover weight-loss drugs for obese patients. If approved by the incoming Trump administration, the rule would significantly expand access to treatment.

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