A mixture picture reveals an injection pen of Zepbound, Eli Lilly’s weight reduction drug, and bins of Wegovy, made by Novo Nordisk.
Reuters
Prescription fills for blockbuster weight reduction medicine within the U.S. greater than doubled in 2024, even with restricted insurance coverage protection and excessive out-of-pocket prices for the remedies, in keeping with information launched Thursday by drug financial savings firm GoodRx.
The figures supply extra proof of the insatiable demand for a buzzy class of medicines referred to as GLP-1 and GIP agonists, which mimic intestine hormones to suppress urge for food and regulate blood sugar. That contains Novo Nordisk‘s weight reduction drug Wegovy and Eli Lilly‘s weight problems remedy Zepbound, which have hefty listing costs of roughly $1,000 monthly earlier than insurance coverage or financial savings playing cards.
Prescription fills for Wegovy and Zepbound elevated by greater than 100% and 300%, respectively, for the reason that begin of 2024. Zepbound’s bounce displays its first yr available on the market, because it was accredited within the U.S. in November 2023. Wegovy received U.S. approval in 2021.
“It’s only a fairly astronomical improve in gross sales, and due to that, a whole lot of eyes are on them round their affordability and accessibility,” GoodRx director of analysis Tori Marsh mentioned in an interview.
The information comes from GoodRx’s new Weight Loss Medications Tracker, which examines fill traits and spending patterns within the U.S. for standard weight reduction drugs.
The excessive fill charges come at the same time as simply 9% of individuals with business insurance coverage have unrestricted protection of Zepbound, and 14% have unrestricted protection of Wegovy, in keeping with GoodRx. That refers to insurance coverage protection with none further hoops for sufferers to leap by means of, akin to prior authorization or larger BMI necessities.
Far larger charges of sufferers — round 60% to 70% — are beneath insurance coverage with extra restrictive protection of the medicine. But Marsh mentioned out-of-pocket prices can add up, even when a affected person has insurance coverage protection for a weight reduction remedy.
The common insured individual taking Zepbound can count on to pay over $2,500 a yr in copays for the drug, she mentioned. GoodRx discovered that individuals spent $231 on common out of pocket for a month-to-month prescription of Zepbound from January 2023 to October this yr.
“Insurance is simply not the stopgap that it was once,” Marsh mentioned.
Meanwhile, almost 1 in 5 individuals with business insurance coverage haven’t any protection of at the least one branded GLP-1 and GIP agonist prescribed for weight reduction.
GoodRx discovered that Americans have overspent by at the least $200 million by paying the complete retail costs for weight reduction drugs as a substitute of leveraging financial savings choices, akin to GoodRx’s coupons or help packages provided by Eli Lilly or Novo Nordisk. GoodRx mentioned it calculated the overpayment quantity based mostly on the common value individuals may have paid for a drug with a GoodRx low cost.
GoodRx mentioned individuals with out insurance coverage can save a median of $250 month-to-month, or $3,000 yearly, utilizing its coupons for weight reduction medicine.
GoodRx’s information is in keeping with different analysis indicating spotty insurance coverage for weight reduction medicine within the U.S. For instance, a survey printed in October discovered that lower than a fifth of huge employers within the nation embody protection of these remedies of their medical insurance plans.
The federal Medicare plan additionally would not cowl weight reduction remedies until they’re accredited and prescribed for one more well being situation. Research has proven that protecting the medicine may considerably increase prices for employers and state and federal governments.
But the Biden administration in November proposed a rule that might enable Medicare and Medicaid to cowl weight reduction medicine for sufferers with weight problems. If greenlit by the incoming Trump administration, the rule would considerably develop entry to the remedies.
