Demand for weight loss drugs is rising, though many insurers won’t cover them

It’s rare to turn on the TV or scroll the internet these days, without hearing about some kind of weight loss drug.

“You see celebrities talking about them, taking them. It’s on late night talk shows,” said Stacie Dusetzina at Vanderbilt University Medical Center.

Lots of regular people are getting their hands on them too, she said. “The companies are selling so much product that they’re having a really hard time keeping up with manufacturing.”

It’s been a big year for weight loss drugs: Prescriptions for Wegovy from Novo Nordisk have increased by 100%; meanwhile, prescriptions for Zepbound from Lilly have increased by 300%, according to a recent report from GoodRx.

Thing is, these drugs are expensive — list prices are generally $1,000 to $1,500 a month, Dusetzina noted. And that expense is often paid out of pocket, pointed out Cynthia Cox at the health policy nonprofit KFF.

“Most health insurance will either not cover the drug or will significantly limit it,” she said. That includes Medicare, Medicaid and private insurance.

Less than 20% of employer-sponsored plans cover these medications. “And in the ACA marketplaces or Obamacare markets, almost no plans cover them for weight loss,” Cox said.

And the plans that do cover them don’t necessarily guarantee affordability, per GoodRx’s Tori Marsh.

“People tend to assume, ‘I have insurance, I’m covered, I’m going to be paying my normal co-pay.’ And that doesn’t seem to be the case, unfortunately, for these medications,” she said.

With insurance, she added, the weight loss drugs can still cost over $2,500 a year.