The anti-obesity drug Zepbound made by Eli Lilly & Co. could be one of the biggest cost drivers for … (+)
The anti-obesity drug Zepbound made by Eli Lilly & Co. could be one of the biggest cost drivers for health insurers, employers and the government health programs that cover it this year.
Already, GLP-1 weight loss prescriptions Wegovy, Rybelsus and Saxenda – along with Ozempic – are the “leading driver” of employer healthcare costs, adding 1% to total premium spending for 2025, data released last fall by the benefits consulting firm, Aon said.
These GLP-1 drugs add to general health care inflation that is expected to increase employer-sponsored health insurance coverage by 9%, eclipsing $16,000 per employee in 2025. Rising premiums, which is higher than the 6.4% increase employers faced in 2024. and in 2023, this will come before “cost reduction strategies” are implemented work, Aon said.
But a new report from GlobalData says Zepbound is poised to surpass 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 released Tuesday by the market research firm.
“Recently, Elie Lilly announced results from its SURMOUNT-5 trial, comparing the effectiveness of Zepbound and Wegovy on an equal footing,” the GlobalData analysis said. “Zepbound, as expected, was more effective in promoting weight loss. While Wegovy caused an average weight loss of 13.7% of body weight, Zepbound promoted approximately 20.2% weight loss in patients.
Zepbound’s launch in a crowded field of GLP-1 drugs comes as more health insurance companies and state Medicaid programs for poor Americans and the Medicare health insurance program for older Americans plan to expand coverage of these treatments hailed for their ability to help people lose weight. weight.
The Biden administration moved in November to require Medicare and Medicaid to cover weight-loss drugs. The proposed new rule, which will require approval from the incoming Trump administration, will not take effect until January 1, 2026, allowing Medicare plans in each market to decide how to handle the change and reflect their costs in the process. call for tenders. say benefits analysts.
Although the Aon report and others note rising health insurance premiums due to a monthly cost that can range from about $400 per month to more than $1,000 for those without coverage depending on their dose , some emphasize the long-term savings in cases of obesity. Americans are losing weight and avoiding more serious and potentially costly health care, like hospitalizations.
“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 surveyed by GlobalData called it “revolutionary.” Today, with Zepbound, the revolution continues and Eli Lilly’s drug is more powerful, and perhaps negotiations with national health services will also make it more profitable than Wegovy.
Zepbound’s list price is $1,086.37 per fill, according to a pricing plan Lilly announced last year, but how much someone pays depends “on your prescription drug plan.” the drugmaker says on its website.
“If you have commercial drug insurance that covers Zepbound, you may be eligible to pay as little as $25 for a one- or three-month supply of Zepbound,” says Eli Lilly. “A month is 28 days and 4 pens. Three months are defined as 84 days and up to 12 pens. If you have commercial drug insurance but it doesn’t cover Zepbound, you may be eligible to pay as little as $650 for a one-month supply of Zepbound.