A class of drugs initially approved for diabetes treatment has captured the public’s and policymakers’ attention as interest in their off-label use for weight loss rises. The weight-loss benefits of these drugs have led to their prescribed use for obesity or overweight treatment. Increased off-label use of these drugs is contributing to supply shortages for people who use these drugs for diabetes and employer health plans and insurers are scrutinizing the prescribing of the drugs. How these drugs are priced will influence how accessible they are to patients, how insurers cover them, and ultimately overall health spending.
This analysis compares list prices for semaglutide—including Ozempic and Rybelsus, which have been approved in the U.S. for diabetes, and Wegovy, which has the same active ingredient and has been approved for weight loss—and tirzepatide (Mounjaro) in the U.S. and other large, wealthy OECD nations. Prices for semaglutide and tirzepatide drugs are higher in the U.S. than in other countries and the U.S. has by far the highest rates of adults with obesity.
Semaglutide drug prices are typically much lower in other large, wealthy countries than found in the U.S. The list price for one month of Ozempic in the U.S. ($936) is over 5 times that in Japan ($169), and about ten times more than in Sweden, the United Kingdom, Australia, and France. A one-month supply of the oral tablet form of semaglutide, Rybelsus, is priced similarly to Ozempic at $936 in the U.S., which is over 4 times as much as the price in the Netherlands ($203). A month’s supply of Wegovy at the maintenance dosage is priced at $1,349 in the U.S., compared to $328 in Germany and $296 in the Netherlands. A month of Mounjaro (tirzepatide) is listed at $1,023 in the U.S. compared to $444 in the Netherlands and $319 in Japan.
The above chart shows list prices available through website searches for 4 weekly shots or 30 days supply of maintenance dosage in the U.S. and other large, high-income countries. Wegovy is available in only a few European Union markets at this point, and not available in Australia and some other countries due to shortages for people using semaglutide for diabetes. In the U.K., Mounjaro is not yet recommended due to lack of sufficient evidence on efficacy and cost-effectiveness.
List prices are not necessarily net prices paid as manufacturers provide insurer rebates and patient coupons. For example, privately insured patients in the U.S. can get Wegovy coupons of $225 per 28-day supply for up to 1 year if their plan covers Wegovy, or $500 per 28-day supply if their private health plan does not cover it. Private insurers and employers in the U.S. may be able to negotiate lower prices with drug manufacturers or get larger rebates.
What impact these drugs have on total health costs in a country will depend not just on the net prices for the drugs, but also on how many people use them. The U.S. has by far the highest rate of obesity among peer nations—a third of adults (33.6%) have obesity in the U.S. compared to an average of 17.1% across peer nations. High rates of obesity and potential market demand for the weight-loss drugs could result in a significantly higher impact on total health spending in the U.S. than in peer nations. KFF polling found about half of adults in the U.S. would be interested in taking prescription weight-loss drugs, though interest drops if the drug is not covered by insurance or after hearing patients might gain weight back after stopping use.
Research is still emerging on long-term health impacts and potential side effects. It is also unclear whether patients would have to take these drugs for the rest of their lives or in combination with other procedures and therapies.
In the U.S., private insurers and employers are figuring out whether and how to cover these weight-loss drugs—coverage and cost-sharing will likely vary by health plan. Medicare is not allowed to cover weight-loss drugs under current law and Medicaid coverage varies by state. Peer nations have similarly variable insurance coverage for these drugs for weight loss. It remains to be seen what share of the costs of weight-loss drugs will be borne by patients or payers.
Higher prices of drugs for weight loss and higher rates of obesity in the U.S. could mean a more significant impact of these drugs on overall health spending in the U.S. than in peer countries.
METHODS
Prices were examined for Ozempic (1.0mg per dose, 4 injections) in the U.S., Australia, Canada, France, Germany, Japan, Netherlands, Sweden, Switzerland, and the U.K.; Rybelsus (7mg dose per tablet, 30 pills) in the U.S., Canada, Japan, the Netherlands, Sweden, and Switzerland; Wegovy (2.4mg per dose, 4 injections) in the U.S., Germany, and Netherlands; and Mounjaro (15mg dose, 4 pens) in the U.S., Japan, and the Netherlands. Prices were not found for any of these drugs in Austria or Belgium. Prices are listed in U.S. dollar ($) based on exchange rates as June 30, 2023.
Originally posted in Peterson KFF – Health System Tracker.
