Novo Nordisk announced that 80% of insured U.S. patients prescribed their popular weight loss treatment, Wegovy, pay less than $25 per month for the drug. Despite Wegovy’s list price being approximately $1,350 per month, the majority of insured Americans seem to bear a minimal monthly cost for the treatment. The revelation comes amid concerns over the high costs of obesity drugs, leading some health insurers to exclude them from their plans. Doug Langa, Novo Nordisk’s Vice President for North America, stated during a third-quarter earnings call that most major health plans and pharmacy benefit managers are covering Wegovy, although some employers are choosing not to provide coverage.
Langa estimated that around 50 million Americans with obesity could potentially be eligible for Wegovy coverage through their health plans. He expressed optimism about the growing coverage and emphasized the company’s commitment to securing more employer coverage and broader access for Americans.
However, the $25 monthly out-of-pocket expense may accumulate over time, especially considering that Wegovy typically requires several months of use for patients to achieve and maintain significant weight loss. Clinical trials indicate a 15% weight loss after 68 weeks of Wegovy treatment. The extended treatment duration contributes to insurers’ reluctance to cover such weight loss drugs due to the strain on budgets, with these medications averaging around $1,000 per month.
Novo Nordisk aims to leverage new data highlighting the cardiovascular benefits of Wegovy to encourage broader insurance coverage. A recent late-stage trial demonstrated a 20% reduction in the risk of cardiovascular events, such as heart attacks and strokes, for individuals using Wegovy. This evidence could potentially influence insurers to cover the medication and similar weight loss treatments. Novo Nordisk’s Chief Financial Officer, Karsten Munk Knudsen, suggested that Wegovy might receive expanded FDA approval for reducing the risk of cardiovascular disease within the next six months. With more than 2 in 5 adults in the U.S. having obesity, the potential expansion of Wegovy’s approval could have significant public health implications.