Prices for the widely used obesity drugs Wegovy and Zepbound have recently dropped, offering hope for better affordability. However, many patients continue to face significant challenges in accessing these medications due to high costs and uneven insurance coverage.
For patients without insurance, the monthly cost remains around $500—a price point that is out of reach for most. Even among insured patients, coverage varies significantly, often leaving individuals to cover hundreds of dollars themselves each month.
Experts emphasize that while lower prices are a positive step, true access depends on sustainable costs for patients. “The medications should be available, the question is at what price and can people sustain that,” said Matt Maciejewski, a Duke University professor specializing in obesity treatment coverage.
Demand for these drugs remains high. Wegovy and Zepbound belong to a class of obesity medications known as GLP-1 receptor agonists. Zepbound generated $2.3 billion in U.S. sales in the first quarter of this year, while Wegovy accounted for nearly $1.9 billion and has about 200,000 weekly prescriptions.
Insurance coverage is improving but remains inconsistent. More large employers are beginning to add these medications to their benefit plans. Novo Nordisk reports that 85% of its insured patients pay $25 or less monthly, thanks to insurance benefits. Some patients with diabetes can also access similar GLP-1 drugs approved for that condition, such as Ozempic and Mounjaro.
However, most state Medicaid programs and Medicare do not cover these drugs for obesity, severely limiting access for many low-income and older adults. Even plans that offer coverage usually pay only part of the cost, resulting in high out-of-pocket expenses.
Drugmakers provide financial assistance programs, but these have limits and don’t always fully cover patients’ costs. Dr. Beverly Tchang, a New York physician advising drug companies, pointed out, “Coverage is not the same as access.”
Insurance providers and employers worry about the long-term costs, as many patients may need these medications indefinitely. Some large employers have removed coverage to control expenses. Pharmacy benefit managers (PBMs) are also selectively covering one brand over another; for example, CVS Health recently dropped Zepbound in favor of Wegovy.
This creates complications for doctors, who must adjust treatment plans when preferred drugs are no longer covered. Dr. Courtney Younglove from Kansas noted that some patients cancel appointments after learning they don’t have drug coverage.
Meanwhile, some compounding pharmacies continue offering cheaper versions of these drugs. These compounded doses are personalized and start at about $165 per month. However, major drugmakers argue these unregulated versions may risk patient safety, leading to lawsuits and the end of some partnerships with telehealth providers.
Though prices have dropped from initial highs, $500 per month is still a heavy financial burden, representing about 14% of the average U.S. per capita annual income of $43,000. Patients sometimes reduce costs by ordering from Canadian pharmacies, which offer lower prices than U.S. suppliers.
Looking ahead, both Novo Nordisk and Eli Lilly are developing pill forms of their obesity drugs, expected to enter the market within the next year. These new options, along with increased competition and international pricing pressure, could help lower costs further.
Doctors and patients remain cautiously hopeful. “I think price wars are going to drive it down,” Dr. Younglove said. “We are still in the early stages, but I have hope.”
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