What Eli Lilly’s new obesity drug Zepbound means for GLP-1 weight-loss medication prices

Eli Lilly’s new weight loss drug Zipbound has a much lower sticker price, $1,060, than competitor Wegovywhich is priced at $1,350.

While a drug’s list price is usually higher than what patients pay at pharmacy checkouts, the lower list price for Zepbound indicates that Eli Lilly may be engaging in price competition with its Danish rival. Novo Nordisk, the pharmaceutical company that makes Wegovy. And it could be the first step in lowering the prices of obesity drugs.

“The more unique manufacturers that produce [weight-loss medications]the greater the price competition, and that benefits all consumers,” said John Cawley, a professor of public policy and economics at Cornell University.

“The fact that Eli Lilly announced a significantly lower list price for Zepbound than Wegovy suggests that they do not want to quietly avoid price competition,” he added. “Zepbound has a higher percentage of weight loss associated with it, so it’s very much a competitor [to Wegovy]… That competition should lead to lower prices.”

This is important for many patients who cannot afford the drug. People with obesity are more likely to be women and have lower incomes, and people with lower incomes are less likely to have good insurance coverage, said Edmond Wickham, a doctor who volunteers on the board of directors of the American Board of Obesity Medicine. , said. This means obesity drugs are more inaccessible to the people who need them most.

About 50 million of the 110 million Americans living with obesity have coverage for anti-obesity drugs, according to Novo Nordisk. But federally funded Medicare does not cover obesity medicine, and Medicaid cover one or more weight loss drugs in only 16 states, according to KFF, a health policy research organization.

Zepbound, Wegovy and Saxenda are GLP-1 drugs which mimics a hormone that suppresses people’s appetite, causing significant weight loss. All three are FDA-approved for obesity treatment. Other GLP-1 agents such as Rybelsus, Ozempiesand Mounjaro are approved to treat type 2 diabetes, but not for the treatment of weight loss management, even though they have the same active ingredients.

But patients rarely pay drugs’ full list prices due to several factors. Drug distributors negotiate lower prices with drug companies, and pharmacies negotiate with distributors to push those prices down further. Then health insurance comes into play.

What patients would pay for Zepbound compared to Wegovy and Saxenda

Zipbound

Eli Lilly’s Zepbound was made available at US pharmacies on December 5. The cost of a one- or three-month Zepbound prescription can be as low as $25 for people with commercial insurance that covers the drug who enroll in Zepbound’s savings card program.

Patients enrolled in the savings program who have commercial insurance that does not cover the drug can pay as low as $550 for a one-month Zepbound prescription. Zepbound will be added to Cigna Healthcare’s commercial formularies starting Dec. 15, according to Eli Lilly. It’s unclear what people without commercial insurance will pay for Zepbound, and Zepbound doesn’t allow patients with government-funded health care programs like Medicaid or Medicare to enroll in its savings program.

Wegovy

About 80% of patients with insurance coverage for Wegovy pay $25 or less, according to a Novo Nordisk statement provided to Quartz. Patients with commercial insurance plans that do not cover the drug, who pay cash, can receive a savings card to reduce the full list price by $500. The card is effective for up to 12 refills of 28-day prescriptions. In other words, without commercial insurance coverage, patients could pay about $850 for a one-month supply. Like Zepbound, only people with commercial or private insurance qualify for Wegovy’s savings program.

Saxenda

About 80% of commercially insured one-month Saxenda prescriptions cost $30 or less from August 2021, according to Novo Nordisk. It is unclear what commercially insured patients without coverage pay for the drug.

Saxenda’s savings program will be discontinued after Dec. 31, and it is unknown what patients will pay for the drug in 2024 and beyond.

Supply issues add to the health equity problem

Because of the deficit of prescription drugs for weight loss this year, patients often have to spend time searching for the drugs—time not typically afforded to lower-paid frontline workers in less flexible work environments.

“I’ve definitely had patients who really want to be on the medicine … but they just don’t have the time to call pharmacies on what might even be a daily basis to find out [if they can] get it there,” Wickham said.