Making Sense of Weight-Loss Drugs’ Cost and Coverage
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Here's your money briefing for Wednesday, June 4th. I'm Callum Borschers for The Wall Street Journal.

It's a confusing time to shop for GLP-1 weight loss drugs like Ozempic and Wegovy. The insurance plan you expected to cover your prescription might not pick up the tab after all. At least there's no longer a shortage of these popular medications. The law of supply and demand means prices will come down, right? So much when it comes to the cost of GLP-1 drugs is it depends. And that's very frustrating for consumers, especially for people who really want access to these drugs and don't have the means to get the access.

We'll try to make sense of the GLP-1 market with WSJ contributor Cheryl Winninger-Munk. That's coming right up after the break. How businesses connect with customers defines their brand. Sierra is the AI platform for building better, more human customer experiences. Fast answers. No canned responses. No hold music. No frustration. Visit sierra.ai to learn more.

GLP-1 weight loss drugs have helped millions of people treat obesity and related conditions like diabetes, but name-brand medications like Ozempic and Wegovy can cost more than $1,000 a month if you're paying out of pocket.

There are ways to reduce your expenses, if you know the playbook. Wall Street Journal contributor Cheryl Winokur-Monk is here to clue us in. Cheryl, why are these drugs so expensive in the first place? Well, for a couple of reasons. So first, newer drugs tend to cost more because of the upfront research and development. There are also patent laws that limit competition and keep prices higher.

So if no one else is making a particular drug and it's a large demand, it becomes an economics issue. Also, the U.S., unlike some other countries that routinely negotiate drug prices, hasn't stepped in to do so. That's why they're more expensive. Cheryl, the FDA says a drug shortage that lasted more than two years is over. That seems good on its face, but there's a catch, right? Online pharmacies like HIMSS and HERS Health could lose the ability to sell knockoff GLP-1s at discounted prices now that there's enough of the real deal to go around.

What does all this mean for patients' bills? Well, it depends. Even though the drugs may no longer be available through certain vendors, the manufacturers are aware of the demand and the need for these drugs, and in some cases are trying to offer lower prices. Also, more employers are at least considering coverage for weight loss, and this is likely to increase as we get more long-term data on the safety of GLP-1 drugs. So you may have to pay more in the short term, but there may be a light at the end of the tunnel.

Well, help me bargain hunt in the short run. Could I get a better price if I go straight to the manufacturer? And what if I'm willing to forego those sleek dosing pens we see in the commercials and just use an old school violin syringe? So much when it comes to the cost of GLP-1 drugs is it depends. And that's very frustrating for consumers, especially for people who really want access to these drugs and don't have the means to get the access.

So it makes sense for people to look at what the manufacturers have to offer and see the dosages and the means of delivery that work for them. It's also good to keep checking back with their insurance company to see if anything's changed because the coverage does change. They may even consider petitioning the insurance to cover if the insurance doesn't cover it.

There are also price comparison sites that consumers can use, sites such as GLP Winner, and you can compare prices of brand-name GLP-1 drugs and get more information on some of the potential options. I suppose the ideal scenario would be for my employer-sponsored health insurance to pay for my weight loss drug. Business leaders I've talked to say they hate covering GLP-1s because they're often a net loss, even though leaner employees have fewer health problems.

How common is it for corporate insurance to cover these medications? I've seen figures suggesting the coverage levels are higher, but conservatively, a survey from the International Foundation of Employee Benefit Plans of Employer Coverage in 2025 found that 36% of employers in the U.S. provide their workers with coverage for GLP-1 drugs to treat weight loss. And meanwhile, 55% provide coverage for the treatment of diabetes only.

I think you are going to see that go up over time. But for now, this is roughly where we're at. What should would-be users know about any additional conditions their employers might place on them? For example, saying you have to also do this weight loss course in addition to the GLP-1.

Well, that's the thing. Because these drugs are so expensive for employers, they do put these conditions on them. So it's not a one-size-fits-all. You're going to really have to check with your employer to see what conditions, if any, there are for getting these drugs covered for what you need it for. And what's the status of Medicare coverage? So Medicare has said that Part D plans, the part of Medicare that's used to cover prescription drugs, have options to cover weight loss drugs like Wagovi if it's used for cardiovascular conditions.

That's not the answer many people were hoping for, given that a Biden administration proposal would have provided coverage of weight loss drugs to about 3.4 million Medicare beneficiaries who are obese.

But proponents are hoping that Medicare plans will cover these drugs more widely in the future. It's a remain-to-be-seen situation. Now, with any expensive drug, there's always the promise of a cheaper generic eventually hitting the market when the patents expire. How far off is that light at the end of the tunnel, though? A ways off, unfortunately, for people who are hoping to see cheaper generics now. The

These patents don't expire for a number of years. And even then, when the drug manufacturers change it slightly, they can apply for another patent. And this could go on for quite a while. But we'll see. President Trump recently signed a sweeping executive order with the goal of cutting prescription drug costs in the U.S. And GLP-1s haven't been singled out, but they're likely to be among those targeted for price cuts. And he's made comments before decrying the high cost of these drugs. So as I said, we'll see.

That's WSJ contributor Cheryl Winokur-Monk. And that's it for Your Money Briefing. This episode was produced by Zoe Kolkin with supervising producer Melanie Roy. I'm Callum Borschers for The Wall Street Journal. Thanks for listening. Think about a bicycle.

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