Insurance cover for Ozempic, Zepbound perished in 2025

This can ultimately make your wallet lighter if you use Ozempic or Zepbound for diabetes or weight loss. From 2024 to 2025, the insurance coverage of Ozempic, which contains Semaglutide, with 22%, based on Goodrx’s analyzes From data from managed Markets Insight and Technology. That meant that another 1.1 million people no longer had such cover for the most filled glucagon-like peptide-1 receptoragonist. During the same time span, the number of people without insurance coverage for another GLP-1 receptoragonist, Zepbound, increased by 14%, which meant that another 4.9 million or so more people were bound by no insurance coverage for the tirzepatide-containing zepbound.

The demand for Ozempic, Zepbound and other GLP-1 agonists continues to rise despite the prices

The insurance coverage for these medicines has therefore fallen, while the demand for them has continued to rise. Another set of analyzes from Goodrx Data from a nationally representative sample of around 50,000 pharmacies in the US revealed that fillings for Zepbound have risen by 300% since the beginning of 2024. In the same period, the fill percentage for Ozempic has doubled. The popularity of GLP-1 receptor agonists has continued to grow after it turned out that taking it can lead to weight loss fairly quickly.

While Zepbound, Wegovy and Saxenda have been officially approved by the US Food and Drug Administration for Weight Loss, the FDA property inspection for Ozempic, Mounjaro and Victoza is specific to the treatment of type 2 diabetes and no weight loss. But how many ticks -likes do you want to bet that the boost is largely due to people they take for weight loss in the popularity of all these medicines?

Of course, taking GLP-1 agonists is not without its potential disadvantages. I’ve already written Forbes About non-so-spared effects called “Ozempic Butt” and “Wegovy Finger.” There are also more serious possible side effects such as Ileus. Moreover, it is not entirely clear what the effects in the longer term can be by taking these medicines time and time again every week, because studies have not expanded for decades.

Moreover, these drugs are not exactly cheap without something like insurance to compensate for their prices. The catalog price of one Ozempic injection is $ 997.58, According to his manufacturer Novo Nordisk. In the meantime, Lilly lists The price of Zepbound is $ 1,086.37 per filling. The most common way to take such medicines is through weekly injections. And as soon as you start these medicines, the plan is usually to keep taking and taking them. That’s because most, if not all lost weight, tend to return shortly after you stopped these medicines. This means that these costs can quickly amount to more than $ 1,300 a month. That is why it would be logical to see if your health insurance policy could cover some, if not all these costs, assuming that you have a health insurance policy.

Insurance coverage for Ozempic, Zepbound and other GLP-1 agonists is complex and changes

Few people would describe health insurance as something simple. Finding out what a certain insurance policy does not cover versus can be as complicated as sorting out the TV series plot Lost. When you try to use a health insurance policy to pay for something, it is not always of buying a Ryan Reynolds cushion on Amazon, where everyone can clearly see the price and you only have to find out if you can afford it and how much of Reynold’s Borst you really want to see every night. The GoodRX analyzes rejected the insurance coverage for GLP-1 receptor agonists in the following three categories:

• No coverage: This means that you are alone to find a way to pay for the medication.
• Limited coverage: Here the insurance company imposes a kind of requirements for you to satisfy before the coverage is possible. You may need to get ‘prior authorization’, which means that the insurance company will revise your case and say ‘yes’ or ‘no’ if you ask to try another treatment first. All this can be difficult in the You-Know-Waar. So people can get frustrated and just continue and pay for the medicines themselves.
• Unlimited coverage: This is a kind of the holy grail for holders of insurance policy. The insurance will continue as usual and pays for the medication. This of course does not necessarily mean that the insurance will make it easy for you. It still can’t cover the full price. Moreover, you may first have to make a deductible before the insurance coverage starts in full.

So for Zepbound, since 2024, the percentage of people with unlimited coverage rose from 9% to 13%. At the same time, however, the percentage with limited coverage fell from 73% to 66%. The net was the aforementioned 14% loss of insurance coverage.

Two medicines, Victoza and Saxenda, which contain liraglutide, another GLP-1 receptor agonist, also suffered the decoration of commercial insurance. The percentage of people without insurance coverage for Victoza has risen by 92%since 2024, corresponding to 31 million people. In the meantime, the percentage change for Saxenda was 47%or 31 million people. At the same time, the number of people who had to do with restrictions on their insurance coverage for Victoza increased by 22%. The new availability of GEneric Liraglutide may have led these changes because at least 9.5 million people received coverage for the generic form in 2025. However, it is not as if it was completely clear to generic liraglutide, or the number of people with disabilities on their insurance coverage of this stuff by 32%.

At the same time, access to Wegovy, again one of the medicines that have actually approved FDA for weight loss, benefits from a little more insurance coverage. Compared to 2024, the percentages of people with unlimited coverage fell from 14.2% to 14.6%, which benefited at least 600,000 people, and the percentage of people with limited coverage went from 67% to 71%, at least 6.3 million people. That meant that it is better for insurance insurance for more than 7 million potential users of Wegovy in 2025. All in all, more than 82% of people are confronted with a kind of disability on their insurance coverage for WegovyZepbound and Saxenda, the three GLP-1 agonists FDA approved for weight loss.

Insurance coverage for Ozempic, Zepbound and other GLP-1 agonists will be a growing care

With the increasing use of GLP-1 agonists, it is not surprising that insurance plans have imposed more restrictions on their coverage. After all, many insurance companies are a profit motive, which means that making a profit is probably quite high on the list of things they want to do. Then there are the listed insurance companies, who not only want to make money, but also for their many, many investors.

Insurance companies in the US have largely been successful in achieving these goals. In 2023, the National Association of Insurance Commissioners provides a snapshot of 10 years of the total financial results of the US health insurance industry. It included the following statement: “The health insurance sector continued its profitability trend, because it reported a (3%) increase in net income to almost $ 25 billion but a modest decrease in profit margin to 2.2% in 2023 compared to the net income of
$ 24 billion and a profit margin of 2.4% in 2022. “So it is not as if large insurance companies have had trouble making ends meet.

Nevertheless, insurance companies could regard the coverage of these GLP-1 receptor agonists as threats for their bottom line, costs that can negatively influence their profit. You could claim that helping people to reduce their body weight can ultimately save other medical costs, assuming that the new body weight is within a range that is good for them. The challenge is that insurance companies do not necessarily look at such financial benefits in the longer term, especially if people change insurance policies when they change jobs every few years.

This is a problem that will not disappear quickly, at least not until the prices of GLP-1 agonists fall. The entrance to more GLP-1 agonists in the market, especially generic, could ultimately lower prices. But until that happens, if you are interested in taking Ozempic, Zepbound or other GLP-1 agonists, you may first want to contact your insurance plan. It can be a little light on the coverage.