Consumers overspent by $200M on weight loss medications in the past year

The news: In the past year, US patients overspent on weight loss medications by at least $200 million due to paying full retail price, according to a new analysis from GoodRx. The study focused on consumers with commercial health insurance since Medicare doesn’t cover GLP-1s exclusively for weight loss.

What’s driving the news? GoodRx points to two separate but related factors driving consumers to spend more than they need to on GLP-1s.

1. Lack of insurance coverage. Most commercial insurance plans don’t cover GLP-1s for weight loss or impose coverage restrictions. Restricted coverage means the insurer requires prior authorization or makes the patient try a less expensive medication first.

• About three-quarters of commercial insurance plans either provide no coverage or restricted coverage for Ozempic and Mounjaro.
• Around 90% of commercial plans provided no coverage or limited coverage of Zepbound and Wegovy.
• Less than one-quarter of health plans said they currently cover GLP-1s for obesity, per a June 2024 Pharmaceutical Strategies Group report.

2. Consumers are not using Rx savings tools. Even when patients can’t use their insurance to pay for GLP-1s, they have other resources at their disposal to bring the price down.

• For example, GoodRx says patients on its platform can save an average of $250 per month, or $3,000 annually, on commonly prescribed GLP-1s.
• Drugmakers separately offer coupons and discount cards for GLP-1 medications, but many patients lack awareness of how they work.

Yes, but: The high cost of GLP-1s without insurance isn’t stopping patients from filling their prescriptions.

• Since the start of 2024, fills for Wegovy and Zepbound increased by 100% and 300%, respectively.

Our take: We’re not certain how GoodRx arrived at its $200 million overspending figure, and we’ll note that the company has skin in the game since it wants consumers to search for Rx coupons on its platform.

The analysis illustrates that lower prices for weight loss medications are possible, even for patients who don’t have insurance coverage or have to jump through hoops to get them covered. They just need to be directed to those resources—by drugmakers, pharmacies, and others in the business of prescription drug sales.

This article is part of EMARKETER’s client-only subscription Briefings—daily newsletters authored by industry analysts who are experts in marketing, advertising, media, and tech trends. To help you finish 2024 strong, and start 2025 off on the right foot, articles like this one—delivering the latest news and insights—are completely free through January 31, 2025. If you want to learn how to get insights like these delivered to your inbox every day, and get access to our data-driven forecasts, reports, and industry benchmarks, schedule a demo with our sales team.