The anti-obesity drug Zepbound, made by Eli Lilly & Co., could be one of the biggest costs … [+]
The anti-obesity drug Zepbound, made by Eli Lilly & Co., could be one of the biggest costs for health insurers, employers and government health programs that provide coverage this year.
The GLP-1 weight loss prescriptions from Wegovy, Rybelsus and Saxenda – along with Ozempic – are already the “biggest driver” of healthcare costs for employers, adding 1% to total premium spending for 2025. facts was released from benefits consultancy Aon last autumn.
These GLP-1 drugs contribute to overall healthcare inflation, which is expected to increase employer-sponsored health insurance coverage by 9%, surpassing $16,000 per employee by 2025. The spike in premiums, which is higher than the 6.4% increase employers faced in 2024 and in 2023, before “cost-saving strategies” are implemented, Aon said.
But a new report from GlobalData indicates that Zepbound is about to overtake other GLP-1 drugs.
“Zepbound’s superior efficacy and strategic market expansion suggest the drug will dominate the obesity market, surpassing Novo Nordisk’s Wegovy (semaglutide),” GlobalData said. in a report that the market research agency published on Tuesday.
“Recently, Eli Lilly has announced the results of its SURMOUNT-5 study, which compares the efficacy of Zepbound and Wegovy on equal grounds,” according to GlobalData’s analysis. “Zepbound was, as expected, more effective at promoting weight loss. While Wegovy caused an average weight loss of 13.7% of body weight, Zepbound promoted a weight loss of approximately 20.2% in patients.”
Zepbound’s launch into a crowded field of GLP-1 drugs comes as more health insurers and state Medicaid programs for poor Americans and the Medicare health insurance program for older Americans consider expanding coverage of these treatments and are being praised for their ability to help people lose. weight.
The Biden administration decided in November to require Medicare and Medicaid to cover weight loss medications. The proposed new rule, which the incoming new Trump administration must approve, would not go into effect until January 1, 2026, leaving individual Medicare plans in the marketplace to decide how to manage the change and reflect their costs in the bidding process. benefits say analysts.
While the Aon report and others note a spike in health insurance premiums due to monthly costs that can range from about $400 per month to more than $1,000 for those without coverage depending on their dosage, some point to the long-term cost savings if they are obese. Americans lose weight and avoid more serious and potentially expensive health care, such as hospitalizations later.
“Wegovy’s impact on the obesity market has been enormous,” GlobalData pharmaceutical analyst Costanza Alciati said in a statement accompanying the report. “Key thought leaders interviewed by GlobalData called it ‘revolutionary.’ Now with Zepbound the revolution continues, and Eli Lilly’s drug is more powerful, and perhaps negotiations with national health authorities will also make it more cost-effective than Wegovy.”
Zepbound’s list price is $1,086.37 per refill, according to a pricing plan Lilly announced last year, but the amount someone pays depends “on your prescription drug insurance plan,” the drug manufacturer says on its website.
“If you have commercial drug insurance with coverage for Zepbound, you may qualify for as little as $25 for a one- or three-month supply of Zepbound,” says Eli Lilly. “A month is defined as 28 days and 4 pens. Three months is defined as 84 days and a maximum of 12 cages. If you have commercial drug insurance but it does not cover Zepbound, you may be eligible for as little as $650 for a one month supply of Zepbound.