Wegovy semaglutide injection pens. Credit: K KStock/Adobe Stock
The new-generation weight-loss drugs work very well at preventing obesity, diabetes and death, but they are still much too expensive to be a good financial value for employer plans or other payers, researchers report in a new paper published by JAMA Health Forum.
Semaglutide, the GLP-1 agonist drug that powers Wegovy, could cost less than $100,000 per qualify-adjusted life year added once its price falls to $1,522 per year, from an average of about $8,412 per year today, the researchers estimate.
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Tirzepatide — a drug that acts both as a GLP-1 agonist and a GIP agonist — is the active ingredient in an even more powerful weight-loss drug, Zepbound.
Tirzepatide will cost less than $100,000 QALY added once its price falls to $4,334 per year, from the current average of $6,236 per year.
A team of researchers led by Dr. Jennifer H. Hwang, a researcher at the University of Chicago medical school, conducted the analysis by using federal government health survey data, information about how much health care spending and productivity loss the weight-loss drugs could prevent, and data on how much patients really pay for weight-loss drugs after taking factors such as manufacturers rebates and discounts into account.
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The researchers estimate, for example, that tirzepatide could cut the obesity rate in half and prevent about 21,000 diabetes cases per 100,000 patients who were either obese or were overweight and had a weight-related health problem.
But tirzepatide costs about $200,000 per QALY gained.
Swiss Re has pointed out that price relief could be coming soon: The U.S. patent on semaglutide will expire in 2032, and the U.S. patent on tirzepatide will expire in 2036.
Even before the patents expire, competition from other new-generation drugs could help lower weight-loss drug prices, the reinsurer predicts.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
