Lilly’s Obesity Drug Zepbound To Be Key 2025 Health Cost Driver
Bruce Japsen – Senior Contributor – Bruce Japsen writes about healthcare business and policy.
Jan 1, 2025
The anti-obesity drug Zepbound made by Eli Lilly & Co. could be one of the biggest cost drivers for health insurers, employers and government health programs that cover it this year.
Already, GLP-1 weight loss prescriptions Wegovy, Rybelsus and Saxenda—along with Ozempic—are the “single biggest driver” of employer health costs, adding 1% to the total premium expense for 2025, data released last fall from the benefits consultancy Aon said.
These GLP-1 drugs are adding to general healthcare inflation that is projected to increase employer-sponsored health insurance coverage by 9%, eclipsing $16,000 per employee in 2025. The spike in premiums, which is higher than the 6.4% increase employers faced in 2024 and in 2023, comes before any “cost savings strategies” are implemented, Aon said.
But a new report from GlobalData indicates Zepbound is poised to overtake other GLP-1 drugs.
“Zepbound’s superior efficacy and strategic market expansion suggest that the drug will dominate the obesity market, surpassing Novo Nordisk’s Wegovy (semaglutide),” GlobalData said in a report the market research firm released Tuesday.
“Recently, Eli Lilly announced the results from its SURMOUNT-5 trial, comparing Zepbound and Wegovy’s efficacy on equal grounds,” GlobalData’s analysis said. “Zepbound, as expected, was more effective in promoting weight loss. While Wegovy caused an average weight loss of 13.7% body weight, Zepbound promoted around 20.2% body weight loss in patients.”
The launch of Zepbound into 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 elderly Americans consider expansion of coverage for these treatments hailed for their ability to help people lose weight.
The Biden administration in November moved to require Medicare and Medicaid to cover weight loss drugs. The proposed new rule, which will require the incoming new Trump administration to approve, would not be effective until Jan. 1, 2026, which will allow individual market Medicare plans to decide how to manage the change and reflect their costs in the bidding process, benefits analysts say.
Though the Aon report and others note a spike in health insurance premiums due to a monthly cost that can range from about $400 a month to more than $1,000 for people without coverage depending on their dosage, some point to the long-term cost savings if obese Americans lose weight and avoid more serious and potentially costly healthcare like hospitalizations down the road.
“The impact of Wegovy on the obesity market has been huge,” GlobalData pharma analyst Costanza Alciati said in a statement accompanying the report. “Key opinion leaders interviewed by GlobalData defined it as “revolutionary.” Now with Zepbound, the revolution continues, and Eli Lilly’s drug is more potent, and perhaps negotiations with national health services will also make it more cost-effective than Wegovy.”
The list price of Zepbound is $1,086.37 per fill, according to a pricing plan Lilly announced last year but the amount someone pays depends “on your prescription drug insurance plan,” the drugmaker says on its web site.
“If you have commercial drug insurance with coverage for Zepbound, you may be eligible to pay as low as $25 for a one- or three-month supply of Zepbound,” Eli Lilly says. “One month is defined as 28 days and 4 pens. Three months is defined as 84 days and up to 12 pens. If you have commercial drug insurance but it does not cover Zepbound, you may be eligible to pay as low as $650 for a 1-month supply of Zepbound.”
