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Benzinga
Benzinga
Business
Kaustubh Bagalkote

FORGOTTEN HISTORY: Wegovy zepbound prices drop but most patients still can t afford long term use coverage is not the same as access says expert | History Defined

Wegovy

Popular obesity treatments Wegovy and Zepbound are seeing price reductions, but patients still face significant barriers to sustained access despite strong market demand.

What Happened: The medications cost around $500 monthly for uninsured patients, while insured coverage remains inconsistent across plans. “Coverage is not the same as access,” said Beverly Tchang, a New York-based physician who advises both Novo Nordisk A/S (NYSE:NVO) and Eli Lilly and Co. (NYSE:LLY), reported the Associated Press.

GLP-1 receptor agonists continue driving substantial revenue for both drugmakers. Zepbound generated $2.3 billion in U.S. first-quarter sales, while Wegovy contributed nearly $1.9 billion with approximately 200,000 weekly prescriptions domestically.

Insurance coverage varies dramatically by provider and plan type. Novo Nordisk reports that 85% of covered U.S. patients pay $25 or less monthly. However, most state Medicaid programs and Medicare exclude obesity coverage, forcing patients to shoulder hundreds in out-of-pocket costs monthly, according to the report.

See Also: AI Assistants Could Break Amazon’s $60 Billion Retail Media Business, Warns VC: ‘It’s Not Just Search At Google — It’s Search Everywhere’

Why It Matters: The regulatory landscape remains complex regarding compounded versions. Despite FDA determinations that drug shortages ended, compounding pharmacies continue selling cheaper alternatives under personalization exceptions.

Hims & Hers Health Inc. (NYSE:HIMS) offers compounded semaglutide starting at $165 monthly, leading to legal challenges from Eli Lilly.

Recent pricing trends show that both companies reduced uninsured patient costs by several hundred dollars from initial launch prices. However, $500 monthly represents approximately 14% of the average U.S. per-capita income at $43,000 annually.

Long-term adherence data reveals persistence challenges that could impact market expansion. Real-world studies show only 8.1% of patients maintained GLP-1 obesity therapy after three years, though one-year persistence for Wegovy improved from 33.2% in 2021 to 62.7% in 2024.

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Disclaimer: This content was partially produced with the help of AI tools and was reviewed and published by Benzinga editors.

Photo courtesy: Tobias Arhelger / Shutterstock.com

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