Tag: GLP-1s

The Drug Changing Medicine

Jul 21, 2026

By EMANUEL SARKEES

The United States is in the middle of what researchers are calling one of the most significant pharmacological developments in modern medicine. GLP-1 receptor agonists, the drug class behind Ozempic and Wegovy, have become able to reduce obesity, lower cardiovascular risk, control blood sugar, and show signals improving areas like addiction and dementia. It is backed by large scale clinical trials and is actively reshaping how physicians think about chronic disease management. The accessibility, however, is not keeping up with the science. The people who will benefit most from GLP-1s are the same people who have no path to receiving them.

This is not a coincidence. It is the outcome of a pricing structure, an insurance system, and a policy environment that have consistently made the same choice, which is to let cost determine who receives care.

What GLP-1s Actually Do

GLP-1s were originally developed to treat Type 2 diabetes. They work by acting similarly to a hormone the gut naturally produces after eating, which signals the brain to reduce appetite, slows digestion, and stabilizes blood sugar levels. The effects have been significant enough that the medical community’s interest has expanded well beyond diabetes management.

A 2023 clinical trial, known as the SELECT trial, found that semaglutide, the active ingredient in Wegovy, reduced the risk of cardiovascular issues like heart attacks and strokes by 20% in patients with obesity who did not have diabetes. That finding alone drew serious attention from cardiologists. Early research is also exploring GLP-1s in alcohol use disorder, sleep apnea, chronic kidney disease, and Alzheimer’s. The amount of potential application is unlike anything seen from a single drug class in recent times.

The Price Problem

The issue is not whether these drugs work. It is whether the system is built to let people use them. Wegovy, the FDA approved version specifically made for weight management, holds a price of around $1,300 per month in the United States without insurance coverage. Ozempic, technically approved for Type 2 diabetes but widely prescribed off label for obesity, runs at a similar cost. As one analysis noted, GLP-1 pricing “increased 442% between 2021 and 2023, creating a market three times larger than cancer spending, with list prices reaching $1,400”. Novo Nordisk and Eli Lilly, the two companies that dominate this market, charge American patients prices that are dramatically higher than what patients pay for the same medications in other countries.

The actual price a patient pays has very little to do with that $1,349 list price and almost everything to do with how they access the drug. With commercial insurance that covers obesity, costs can fall to around $25 a month, though that requires a plan that actually covers weight loss medications and prior authorization that actually gets approved. The Wegovy pill is available directly through NovoCare at $149 per month, the lowest price point ever for an FDA-approved GLP-1 weight loss medication. Zepbound starts at $299 per month through LillyDirect for patients who pay out of pocket. The government’s TrumpRx platform offers GLP-1s at around $350 per month for cash-paying patients who do not have coverage. Compounded versions through telehealth platforms like Ro and Hers run anywhere from $99 to $349 per month, though the FDA is actively restricting that market. And as of July 1, 2026, eligible Medicare beneficiaries can access Wegovy, Zepbound, and Foundayo at a flat $50 per month through the new Medicare GLP-1 Bridge program. That is a 27-times spread between the lowest and highest price for the exact same drug, determined not by what the medicine costs to make, but almost entirely by who you are when you walk up to the pharmacy counter. And for the uninsured, low income patient with no Medicare, no qualifying commercial plan, and no compounding option, none of those prices are on the table at all.

At $1,300 per month, the annual cost of Wegovy exceeds $15,000. For millions of Americans, that number is not just high, but is completely out of reach. That gap in pricing is not accidental. In countries where governments negotiate drug prices directly, the same medication costs a fraction of what Americans pay. The United States remains one of the only developed nations that does not regulate pharmaceutical pricing at the federal level, and patients suffer the difference.

Insurance coverage for GLP-1s follows a path that is both frustrating and familiar.

The price of Ozempic is a meaningless phrase

Jul 16, 2026

By JOHN SAMARAS

Ask what Ozempic costs. The honest answer runs from $25 a month to $1,100 a month, and every number in that range is real, published, and defensible. A phrase that covers a forty-four-fold spread is not a price. It is a fog, and patients make four-figure annual decisions inside it.

I run GLP Chart, an independent GLP-1 price index. The index shows that “the price of Ozempic” fails as a concept for three stacked reasons. The molecule sells in five forms under four names. Each form sells through different channels at different prices. And the advertised price rarely survives to month four.

One molecule, five forms

Ozempic is semaglutide, branded for type 2 diabetes. The same molecule is Wegovy when approved for weight loss, sold as a weekly pen and, since 2026, a daily pill. It is Rybelsus in the older oral form. And 503A compounding pharmacies still sell it as compounded semaglutide where the rules allow, though the FDA’s compounding restrictions and the manufacturer lawsuits thinned that market through 2025 and 2026.

When someone says “Ozempic price,” they almost always mean “what will semaglutide cost me.” Those are different questions with different answers.

Is getting people off weight loss medications the right move?

May 6, 2024

By RICHARD FRANK

Demand for GLP-1 medications soared last year and shows no signs of stopping in 2024. Employers and health plans are understandably anxious about how long they should expect to pay for these pricey drugs. They’re itching for an easy off-ramp.

Some solutions are cropping up to pave the way. Many of them claim they can help patients reap the benefits of GLP-1s within a short time frame, and get them off the drugs within 12 months to save costs. But the data doesn’t support that promise. In fact, studies suggest some patients may need to stay on the drugs indefinitely to sustain outcomes while other patients may be able to discontinue the drugs and at least maintain their cardiometabolic risk reduction even if they cannot maintain all of their weight loss.

A better strategy to control costs is to more accurately pinpoint those who really need the drugs—and keep those who don’t off of them from the start. Of course, there will be times when deprescribing is appropriate, and we need to clinically support patients through that process. But one-size-fits-all solutions centered on medication as a silver bullet to obesity are only setting up patients and payers for failure. Similarly, those whose sole promise is to deprescribe, don’t follow the evidence.

Prescribing GLP-1s with the goal to deprescribe is foolhardy

GLP-1s treat obesity, but they don’t cure it. GLP-1 agonists increase the body’s own insulin production and slow the movement of food from the stomach to the small intestine. The drugs help people eat less by curbing cravings and boosting satiety. Studies show that once people go off semaglutide, the cravings come back in full force—and so does much of the weight.

While GLP-1 medications produce nearly miraculous outcomes in some people, they’re no quick fix. Obesity is a complex chronic disease. Drugs alone can’t solve for genetic predisposition, behaviors, mental and emotional components, social determinants of health, and other compounding elements that contribute to obesity. In the right circumstances, drugs can give people a solid leg up in better managing those contributing factors—but they’re not for everyone.

Keto is not a sustainable replacement for GLP-1s

Highly restrictive diets like the keto diet aren’t for everyone either. Keto requires a drastic reduction in carbohydrate intake, which can be difficult to maintain long-term. Not to mention, the high-fat content of keto diets can also lead to other health issues and isn’t conducive to tapering off of GLP-1 medications. Side effects from the drugs can make a high-fat diet difficult to tolerate.

It’s good to be wary of solutions that promise an off-ramp by way of highly restrictive diets. While a keto diet may help people lose weight in the short term, studies show that weight loss is rarely sustained over the long run and may be detrimental to overhaul health. The diet is associated with many complications that often lead to hospital admissions for dehydration, electrolyte disturbances, and hypoglycemia.

Triage the right care to the right people at the right time

Obesity’s complex nature requires a personalized approach to treatment that delivers the right care to the right people at the right time. That takes a whole care team of specialized providers—like registered dietitians, health coaches, and prescribing physicians to help people at various stages of the disease. And since obesity often occurs alongside other cardiometabolic conditions like hypertension, diabetes, COPD, and more, patients need the help of specialists who understand how those different conditions interact.

What could we do if GLP-1 weight loss drugs were free? Would our obesity epidemic be solved for good?

Mar 13, 2024

By CECI CONNOLY and SAMI INKINEN

Unless you have been living under a rock, you likely have heard the names Ozempic, Wegovy or Mounjaro. Or perhaps been humming the jingle. Rarely has a class of drugs (in this case, GLP-1s) achieved such widespread attention in popular culture and the media, which has people clamoring for them in every doctor’s office in the nation.

And for good reason. What we know is that the efficacy and safety profile of these medications is substantially better than any weight loss drug in the past, while our obesity epidemic has only ballooned. As organizations committed to sound science and holistic patient care, we are encouraged by the benefits of these new therapies for diabetes. The clinical evidence shows that GLP-1s are highly effective for controlling blood glucose levels among patients living with Type 2 diabetes and certain co-morbidities. GLP-1s may even improve heart health for high-risk patients.

To date, the biggest worry with these weight loss therapeutics has been the hefty price tag, ranging from $800 to $1700 per person, per month. Conservatively, these weekly injections could cost the nation more than $100 billion dollars annually. Already, state Medicaid budgets are sagging under the financial burden. In North Carolina, for example, officials dropped coverage of GLP-1s for obesity, noting that two drugs alone would cost about $1 billion over 6 years, and that’s with a nice discount.

As troubling as the cost is, what we don’t know is what should really worry us. Amidst the excitement over patients rapidly shedding up to 15% of their body mass, fundamental questions remain about who should be taking GLP-1s, at what dosages and what the long-term health and economic consequences will be for patients and society. Ultimately, the price paid to people’s long-term health may be more concerning than the price paid out-of-pocket.

With the recent release of the SELECT trial data highlighting limitations of existing published studies of GLP-1s, it is now even clearer that the public isn’t getting the full picture.

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