GLP-1s go from niche to mainstream
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New pricing deals and aggressive marketing are transforming expensive GLP-1 weight-loss drugs into mainstream treatments and creating the next mega-market for the pharmaceutical industry.
Why it matters: Americans have shown they're willing to pay thousands of dollars out of pocket for the treatments — making them more popular than ever even as insurers try to pump the brakes by restricting coverage.
- There may be more deals on the way. Eli Lilly and Novo Nordisk have already reduced prices for the leading GLP-1s in their recent agreement with President Trump in exchange for expanded access to millions of people on Medicare.
- Medical researchers also continue to find promising new medical uses for GLP-1s, including treatment of addiction, COPD and dementia — though not every application has proven successful.
Driving the news: The Trump drug pricing deal was part a dizzying series of recent developments.
- Last week, Eli Lilly reached a market valuation of $1 trillion, capping a surge that started two years ago with the launch of its GLP-1, Zepbound.
- Novo Nordisk and Lilly also took steps to start selling GLP-1s directly to employers next year.
- Manufacturers are continuing to develop pill forms of GLP-1s — like Novo's oral drug Rybelsus — that eliminate the need for injections and are easier to transport and store.
By the numbers: 1 in 8 Americans say they're currently taking a GLP-1 such as Ozempic or Wegovy either to lose weight or treat a chronic condition, per KFF.
- While most say their insurance picked up at least some of the cost, about a quarter (27%) report they paid the full cost themselves.
- 3 in 4 say they got the drugs they took from one of their doctors, while about 1 in 6 (17%) say they got them from an online provider or website.
Yes, but: The drugs still come with unpleasant side effects like nausea, vomiting and diarrhea that lead many people to quit. In most of those cases, their weight returns.
- Physicians note that many patients start GLP-1s to treat obesity without proper counseling from a health provider about diet and exercise and how to manage the side effects.
The drugs' potential beyond weight loss and diabetes still isn't fully clear. This week, Novo Nordisk reported its Rybelsus pill failed to delay the progression of Alzheimer's disease in a pair of clinical trials, dealing a blow to the company's hopes of growing the market.
- One key goal of medical researchers is to learn more about the way GLP-1 signals travel from the gut to the brain and affect reward pathways.
- GLP-1s are being evaluated for conditions including alcohol, opioid and tobacco use disorder, though researchers say more and larger studies are needed.
- There also are signs that GLP-1s for diabetes could slow motor issues in patients with early stage Parkinson's disease.
What we're watching: Whether workplace insurance will shift more of the cost burden of GLP-1s to workers.
- David Risinger, an analyst for the investment bank Leerink Partners, noted an instance in which an employer used direct-to-consumer websites to provide access to GLP-1s and gave employees a debit card to cover 50% of the cost.
- Because the pill forms of GLP-1s are easier to manufacture than injectables, it's possible they'll cost less and be more attractive for insurers to cover, Richard Siegel, an endocrinologist at Tufts Medical Center, told NPR.
- The pressure to stay competitive was apparent in the recent bidding war for obesity drugmaker Metsera, which Pfizer recently agreed to buy for as much as $10 billion, outbidding Novo Nordisk.
The bottom line: We may just be watching the beginning of the drugs' rise into the mainstream — but there's still a ways to go before they're cheaper and easy to get.
