GLP-1 prescriptions for weight loss are shooting up, despite obstacles

Dive Brief:

• More adults are taking GLP-1 drugs to control their weight, despite recent shortages and high list prices, according to new research.
• The percentage of overweight or obese adults prescribed a GLP-1 jumped from 0.3% in 2019 to 2.05% in 2024 — an almost 587% increase, according to an analysis of commercial claims by nonprofit Fair Health.
• Yet only a small percentage of adults with overweight or obesity receive treatment, resulting in a massive unaddressed patient population that explains why drug manufacturers are salivating over the nascent obesity market. More than 80% of obese or overweight patients didn’t receive a GLP-1 prescription, bariatric surgery or behavioral healthcare in 2024, Fair Health found.

Dive Insight:

Fair Health trawled its repository of more than 51 billion commercial claims records to analyze trends in obesity and GLP-1 coverage.

GLP-1s, or glucagon-like peptide-1 receptor agonists, work by mimicking a hormone that decreases blood sugar levels and inhibits appetite. The drugs were originally created to treat diabetes, but more recently have shown efficacy in treating a variety of other conditions, including weight loss.

GLP-1 adoption has skyrocketed as a result. Roughly half of all patients who got a GLP-1 prescription last year did so for weight loss, Fair Health found.

The sheer demand for the drugs for weight loss is more clear when patients with Type 2 diabetes are factored out of the data: The percentage of obese or overweight adults who didn’t also have diabetes prescribed GLP-1s increased a whopping 1,961% between 2019 and 2024, according to the nonprofit.

Along with giving new hope to patients who struggle to lose and keep off excess weight, GLP-1s have created a windfall for drug manufacturers, which are competing aggressively in the burgeoning weight loss market. Analysts estimate that sales of anti-obesity medications could reach $100 billion by 2030.

Currently, three GLP-1 drugs are approved by the Food and Drug Administration for weight management: Saxenda and Wegovy, both manufactured by Danish drugmaker Novo Nordisk; and Zepbound, manufactured by Indianapolis-based Eli Lilly.

Though only recently approved — Saxenda, the first GLP-1 greenlit for obesity and overweight treatment, was approved in 2014, but Wegovy, a significantly more effective version, wasn’t approved until 2021 — the drugs quickly began raking in billions of dollars for their manufacturers.

Last year, Novo brought in $9.9 billion in sales from Wegovy and Saxenda, while Eli Lilly brought in $4.9 billion from Zepbound. It was the first full year Zepbound was approved for weight management.

However, the two drugmakers have struggled to maintain dominance in the GLP-1 market, after sky-high demand created shortages for the drugs last year. That temporarily allowed telehealth companies to work with compounding pharmacies and sell knock-off medications.

GLP-1s are now no longer in shortage, restoring exclusive selling rights to the drug manufacturers. Yet the competition, however brief, cut into drugmakers’ expected profits for 2025 and sparked a leadership turnover at Novo.

Another challenge has been the medications’ price. Novo’s Wegovy and Lilly’s Zepbound, for example, are listed at about $1,350 and $1,060 per month respectively before any discounts, according to the Institute for Clinical and Economic Review.

Given patients need to take GLP-1s in perpetuity to continue reaping the drugs’ benefits, that creates a significant financial burden for payers. Fewer than 1 in 5 employer-sponsored plans covered GLP-1s for weight loss in 2024, with many citing cost as the limiting factor.

In an attempt to sweeten the deal, manufacturers have been inking deals with pharmacy middlemen to lessen the financial risk of GLP-1s.

Earlier this month, Novo and Lilly partnered with Cigna’s health services subsidiary to discount GLP-1s for employer and health plan clients, and cap patients’ copays for the weight loss medications. That agreement followed a similar deal between CVS Caremark and Novo to give Wegovy preferred access on the massive pharmacy benefit manager’s standard formulary.

Obesity has long been a challenge for the U.S. The condition, which increases the risk of other diseases like heart disease and diabetes, affects more than 40% of Americans, according to the Centers for Disease Control and Prevention. That percentage is expected to reach 50% by 2030.

Still, there’s a particular microscope on the issue today, due to the “Make America Healthy Again” movement spearheaded by HHS Secretary Robert F. Kennedy Jr. Kennedy has blamed poor dietary choices for rising incidences of chronic conditions like obesity, including in a high-profile report the White House released last week.

Kennedy has also criticized the pharmaceutical industry for profiting off of Americans’ poor health, including by offering GLP-1s for weight loss when he says the issue could be better addressed with healthier food and lifestyle choices.

Kennedy’s antipathy to pharmacological solutions could be one reason why the Trump administration declined to allow Medicare, the federal insurance program for elderly Americans, to cover obesity drugs in April. The policy would have also carried steep costs, putting taxpayers on the hook for $40 billion in additional spending over a decade.

However, Medicare is currently negotiating lower prices for Novo Nordisk’s Wegovy and Ozempic in Medicare under the Inflation Reduction Act. The new rates, which take effect in 2027, are expected to eventually deflate prices for other GLP-1s.

Also of interest in Fair Health’s report, the nonprofit found that the increasing prevalence of GLP-1s coincided with a drop in bariatric surgery, a type of surgery that modifies patients’ stomachs or intestines, reiterating other research suggesting that GLP-1 usage could be replacing other types of obesity treatment.

And, more GLP-1 prescribing is tied to a decrease in behavioral healthcare — a somewhat concerning trend, given research suggesting patients on such drugs have a higher risk of depression, anxiety and suicidal ideation.