GLP-1 medications such as Ozempic, Wegovy and Zepbound deliver strong health value but create massive budget pressures for insurers. Researchers from the University of Mississippi highlight the gap between cost-effectiveness and affordability. Coverage remains restricted for many eligible patients.
An analysis by the Institute for Clinical and Economic Review found that GLP-1 drugs provide substantial health improvements that justify their price. However, the large number of potential users pushes spending far beyond the $821 million annual budget impact threshold set by ICER.
Sujith Ramachandran, associate professor at the University of Mississippi, noted that even modest uptake among the roughly 40 percent of Americans with obesity would trigger billions in new insurer costs. Long-term savings from reduced cardiovascular, liver and kidney issues remain unproven in current data.
Many patients discontinue treatment within the first year due to cost, side effects or reaching weight goals. Ramachandran stressed that sustained benefits require ongoing lifestyle support, including dietitians and fitness resources, in addition to medication.
Compounded versions of these drugs carry safety risks because they lack FDA oversight, according to doctoral candidate Liang-Yuan Lin. Coverage is expanding for conditions such as diabetes and sleep apnea but tightening in other areas.
