Weight Loss Drugs in the U.S. Are More Costly

Weight loss drugs can be five times more expensive in the United States than in other large, wealthy countries, according to a recent analysis.

The analysis is from the Kaiser Family Foundation (KFF) and looked at the prices of Ozempic and Rybelsus (semaglutide) and Mounjaro (tirzepatide), which are drugs intended to treat diabetes but can be prescribed off-label for weight loss, and Wegovy (semaglutide) which has been approved in the U.S. as a weight loss treatment.

The report compares prices of these medications in the U.S. and other large, wealthy OECD nations like Australia, Canada, Germany, France, Japan, the Netherlands, Sweden, Switzerland, and the United Kingdom.

Semaglutide drug prices are typically much lower in other countries analyzed than in the U.S. For example, a one-month supply of Ozempic in the U.S. ($936) is over five times as much as the price in Japan ($169), and about 10 times more than in Sweden, the U.K., Australia, and France.

A one month of Rybelsus, which is priced similarly to Ozempic at $936 in the U.S., is over four times that in the Netherlands ($203) and more than 13 times that in Japan ($69).

Whereas 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., which is more than twice the price in the Netherlands ($444) and over three times that in Japan ($319).

The analysis included list prices available through website searches for four weekly shots or 30 days supply of maintenance dosage. However, Wegovy is currently available in only a few European Union (E.U) countries and is not available in Australia and some other countries due to shortages for people using semaglutide for diabetes.

Moreover, list prices are not necessarily net prices paid, as manufacturers provide insurer rebates and patient coupons in the U.S. For example, if the private insurance plan covers Wegovy, a 28-day supply for up to one year may cost $225. However, the patients may need to pay $500 out-of-pocket if their private plan does not cover Wegovy.

And because peer nations have similarly variable insurance coverage for these weight loss drugs, it is unclear what share of the costs of weight-loss drugs will be borne by patients or payers.

According to the analysis, the impact of these drugs 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 obesity rate among peer nations — a third of American adults (33.6%) have obesity 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," the analysis states.

Under current law, Medicare is not allowed to cover weight-loss drugs, and Medicaid coverage varies by state.

These weight loss drugs appear to be highly effective. For example, people taking Wegovy and Ozempic lost about 15% of their body weight within a 68-week period in the clinical trials. Other studies and anecdotal evidence suggest that medications may play a role in preventing dementia or treating addiction.

However, these weight loss drugs are associated with severe side effects, such as malnutrition, possible thyroid cancer risks, and stomach paralysis, and are now being investigated over reports of suicidal thoughts.

Moreover, it is unclear if patients would have to take these medications for the rest of their lives or in combination with other procedures and therapies.