GLP-1 Cost Statistics (2026)

Of the 15 drugs CMS selected for the second cycle of Medicare price negotiation, semaglutide is the biggest by a wide margin. Ozempic, Rybelsus and Wegovy together accounted for $15.16 billion of gross covered Part D prescription drug costs in 2024. The next largest, Trelegy Ellipta, cost $5.3 billion, less than a third as much.

2,282,000 Medicare Part D enrollees were dispensed one of the three in 2024. Only Trelegy Ellipta came close on user count, at 1,269,000.

The 15 drugs together accounted for $42.5 billion, about 15% of all Part D gross covered drug costs in 2024. Semaglutide alone was more than a third of that.

CMS agreed a maximum fair price of $274 for a 30-day supply, against a 2024 list price of $959. That is a 71% discount, and it takes effect on 1 January 2027.

Two drugs in the same programme were cut harder in percentage terms: Janumet at 85% and Tradjenta at 84%, both older type 2 diabetes drugs with much smaller spend. Xtandi, at 48%, and Austedo, at 38%, were cut least.

The discount is measured against the wholesale acquisition cost, which is a list price rather than what any payer actually paid after rebates. CMS says the negotiated prices would have saved an estimated $12 billion in 2024 across all 15 drugs, or about 44% of net spending, falling to $8.5 billion and 36% once Coverage Gap Discount Program spending is counted.

CMS projects that people enrolled in Medicare prescription drug coverage would save about $685 million in out-of-pocket costs in 2027 under the standard benefit design, across all 15 drugs.

In 2024, Part D enrollees paid $1.7 billion out of pocket for these 15 drugs. That figure is the one to watch, because it is what people actually handed over rather than what the programme spent.

Coverage is still not automatic. Medicare Part D has historically been barred from covering drugs used purely for weight loss, which is why the negotiated semaglutide price is framed around type 2 diabetes and cardiovascular indications rather than obesity alone.

A 30-day supply of semaglutide has at least four different prices depending on who is paying and how. The 2024 wholesale acquisition cost was $959. The Medicare negotiated price from 2027 is $274. Novo Nordisk's own self-pay price through NovoCare is $349, or $199 for the first two fills at the lowest doses.

Tirzepatide follows the same pattern. Eli Lilly's published LillyDirect self-pay prices are $499 a month for Zepbound 7.5 mg and $699 for 10 mg, 12.5 mg and 15 mg, with lower prices available through the manufacturer's own refill programme.

The gap between list and cash price is the clearest signal that the list price is a negotiating artefact rather than a real number. A patient with no insurance can buy direct from the manufacturer for roughly a third of the list price.

Novo Nordisk states that it reserves the right to modify or cancel the Wegovy savings programme at any time, and the introductory $199 price is time-limited to fills through 31 December 2026.

Eli Lilly's savings card carries a cap on total savings and a limit of 13 prescription fills per calendar year, and the company reserves the right to terminate or amend eligibility without notice.

For a drug that may be taken for years, a price that can be withdrawn at the manufacturer's discretion is a different financial commitment from one set by a contract or a statute. That is the practical difference between a cash price and a negotiated one.

In KFF's May 2024 poll, 12% of adults said they had ever taken a GLP-1 and 6% said they were currently taking one. By the poll fielded 27 October to 2 November 2025, 18% had ever taken one and 12% were currently taking one.

Current use is highest among adults aged 50 to 64, at 22%, and lowest among those 65 and over, at 9%. Women report current use at 15% against 9% for men.

The 2024 poll also found that 43% of adults who had been told they had diabetes had taken one, along with a quarter of those told they had heart disease and 22% of those told they were overweight or obese in the past five years.

56% of GLP-1 users told KFF the drugs were difficult to afford. Among users with insurance the figure was almost identical, at 55%, which is the finding that matters: having coverage did not solve the affordability problem for most people who had it.

27% of insured users said they paid the full cost themselves, meaning their plan covered nothing.

14% of users stopped taking them because of cost, and 13% stopped because of side effects. Cost was the larger reason people discontinued.

Among firms offering health benefits in 2025, 16% of those with 200 to 999 workers cover GLP-1s when used primarily for weight loss. That rises to 30% at 1,000 to 4,999 workers and 43% at 5,000 or more.

The largest firms moved fastest: 43% in 2025 against 28% in 2024.

34% of firms that do cover them attach conditions, requiring enrollees to meet a dietitian, case manager or therapist, or to take part in a lifestyle programme, before coverage applies.

44% of covering firms with 1,000 to 4,999 workers, and 59% of those with 5,000 or more, said use of these medications for weight loss was higher than they expected.

43% and 66% respectively said covering them had a significant impact on the health plan's prescription drug spending.

KFF's own summary notes that discussions with individual employers suggest some have stopped covering these medications for weight loss, and that a few have tightened coverage even for people with diabetes.

Among firms with 200 or more workers that offer health benefits and do not currently cover GLP-1s for weight loss, only 1% say they are very likely to begin covering them within the next 12 months.

That figure is the strongest available signal about where employer coverage goes next. The expansion of the last two years was concentrated among the largest employers, and the firms that have not moved are not signalling that they intend to.

For an employee, the practical consequence is that coverage is a function of employer size and plan design rather than of medical need, and it can be withdrawn at renewal.

The CDC puts adult obesity prevalence at 41.9% during 2017 to March 2020, up from 30.5% in 1999-2000. Severe obesity rose from 4.7% to 9.2% over the same period.

That is more than 100 million adults with obesity and more than 22 million with severe obesity.

The CDC estimates obesity accounted for nearly $173 billion in medical expenditures in 2019 dollars, which is the number that makes both the coverage argument and the cost argument at the same time.

A drug taken indefinitely by a large share of a covered population is a different financial object from a drug taken briefly by a few people. That is the whole of the payer problem, and it explains why coverage decisions have moved as fast as they have in both directions.

At the 2024 list price of $959 a month, a year of treatment is roughly $11,500 per person. At the Medicare negotiated price of $274, it is about $3,300. At Novo Nordisk's $349 self-pay price, about $4,200.

The spread between those figures, on a population measured in millions, is the reason the negotiated price is the single most consequential number on this page.

It applies to Medicare, not to commercial insurance or to people paying cash. An employer plan is unaffected by it.

It takes effect on 1 January 2027, so it changes nothing about what anybody pays in 2026.

And it is a price for the programme rather than a coverage decision. A negotiated price does not create an entitlement to the drug for a use the plan does not cover.

Check what a month means. Novo Nordisk defines one month of Wegovy as one box of four pens. Eli Lilly defines a Zepbound month as 28 days and up to four single-dose pens. Those are not the same period.

Check whether the price is tied to a dose. Zepbound self-pay runs $499 at 7.5 mg and $699 at 10 mg and above, so a dose increase is a price increase.

Check whether it counts toward your deductible. Novo Nordisk states explicitly that money spent under its savings offer does not count toward a deductible or out-of-pocket maximum and cannot be submitted for reimbursement.

Every price, spend figure and user count in the Medicare sections is read from the CMS fact sheet for initial price applicability year 2027, including the per-package maximum fair prices.

Coverage figures are from the KFF 2025 Employer Health Benefits Survey summary of findings. Use and affordability figures are from KFF's tracking poll fielded 27 October to 2 November 2025, with the May 2024 poll used only for the trend.

Self-pay prices are taken from Novo Nordisk's and Eli Lilly's own published pages, which are primary for their own pricing and which both state that the terms can change.