Vacations are on hold, dinners out skipped, and doses stretched — all so patients can keep taking weight-loss drugs like Wegovy and Zepbound as insurers pull back coverage in 2025.
Physicians say insurance coverage is more limited this year, according to Reuters. As a result, many employers are removing the costly drugs from benefit plans.
These GLP-1 drugs, administered weekly, carry U.S. insurer list prices exceeding $1,000 monthly.
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Csh-paying customers can obtain them directly from drugmakers for $499 a month under certain purchase conditions. But that still represents a significant expense for most households.
Doctors emphasize that patients taking these medications are also advised to follow proper diet and exercise routines.
However, clinical trials indicate that discontinuing GLP-1 treatment often leads to regaining lost weight, making long-term use critical for sustained results. For this reason, physicians rarely recommend stopping the drugs unless a patient has a specific, short-term goal, such as losing weight for fertility procedures or qualifying for an organ transplant.
Over the past year, patients who were initially hesitant about ongoing obesity treatment have become more accepting of long-term medication use. Doctors attribute this shift to growing awareness of the challenges in maintaining weight loss without pharmacological support.
A 2023 real-world study by Prime Therapeutics found that just 27% of users remained adherent for one year, and only 15% persisted for two years. At three years, only 8.1% of users were still on treatment.
Even the best-performing drug, Novo Nordisk A/S’ (NYSE:NVO) Wegovy, had a three-year persistence rate of just 14.3%.
Eli Lilly and Co. (NYSE:LLY) owns Zepbound.
Over three years, only 12.5% of users met the standard for adherence based on medication possession. More than one-third switched to a different GLP-1 therapy.
Still, the high price remains a barrier. Several obesity specialists expressed hope that increased competition could ease costs.
New weight-loss options, including oral medications expected as early as next year, could put downward pressure on prices and expand access to treatment.
However, the Trump administration is preparing a pilot program that could allow some Americans on Medicare and Medicaid to access popular and costly weight-loss medications.
The plan, still in development, would permit state Medicaid programs and Medicare Part D plans to voluntarily cover GLP-1 drugs
The initiative, set to launch in April 2026 for Medicaid and January 2027 for Medicare, would run through the Center for Medicare and Medicaid Innovation.
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