A recent analysis by the health policy organization KFF reveals that blockbuster weight-loss drugs are priced considerably higher in the United States compared to other large, high-income countries. This comes at a time when many U.S. health insurers are grappling with the exorbitant costs of these medications and are excluding them from their coverage plans.
These weight-loss drugs, known as GLP-1 agonists, have an average monthly cost of about $1,000 and are typically taken over an extended period. However, their steep prices strain insurers’ budgets, and many of the 100 million obese American adults cannot afford to pay for these drugs out of pocket.
KFF’s analysis compared list prices, the initial price set by drug manufacturers before insurance or discounts are applied. While some countries negotiate with drugmakers to establish lower list prices, others, like the U.S., do not, leading to significant price discrepancies.
For instance, Novo Nordisk’s diabetes drug Ozempic used off-label for weight loss, has a list price of $936 for a 30-day supply in the U.S. In contrast, it is priced at $168 in Japan, $103 in Germany, $96 in Sweden, and $83 in France. Similarly, Novo Nordisk’s Wegovy, which has the same active ingredient as Ozempic and is approved for weight loss, has a list price of over $1,300 in the U.S., compared to $328 in Germany.
Eli Lilly’s diabetes drug Mounjaro also used off-label for weight loss, has a list price of $1,023 in the U.S. but is priced at $319 in Japan and $444 in the Netherlands.
These high list prices, coupled with inconsistent insurance coverage, hinder patients’ access to these medications. A recent KFF survey indicates that while nearly half of U.S. adults are interested in prescription weight-loss drugs, this interest drops to 16% if insurance does not cover the medication. The survey also highlights that around 80% of adults believe insurance companies should cover the cost of weight-loss drugs for overweight or obese individuals.
Novo Nordisk’s recent trial data suggesting health benefits beyond weight loss could intensify pressure on U.S. insurers to cover these drugs. The study found that Wegovy reduced the risk of heart-related issues and death in overweight or obese patients with cardiovascular disease by 20%. However, insurers are awaiting further data before considering broader coverage for these medications.
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