A whopping 1 in 8 U.S. adults have taken GLP-1 drugs like Wegovy and Ozempic for weight loss and related conditions. Their popularity and efficacy have sparked a prescription-writing frenzy in recent years, leaving both medications on the FDA’s drug shortage list since May 2023.
But even when the supply rebounds, access to these drugs will remain out of reach for the majority of Americans. That’s because brand-name GLP-1 drugs range from $11,000 to $16,000 a year, prices that are unaffordable for most people.
Attempts to control prices through legislation face significant hurdles, both in the divided halls of Congress and in the courts, where determined legal challengers await. Senator Bernie Sanders, chair of the Senate Health Committee, hopes that applying pressure at upcoming hearings will force Novo Nordisk, maker of Wegovy and Ozempic, to lower prices voluntarily. History shows that pharmaceutical companies rarely bend on prices, even in the face of public scrutiny.
Fortunately, Congress can implement a straightforward solution to make these drugs affordable, thereby improving the nation’s financial and physical health. Before explaining the solution, we must first understand the obesity struggle in this country and the urgent need for an effective, affordable weight-loss medication.
Framing The Obesity Epidemic
Around 42% of American adults are obese, putting them at dramatically elevated risk for a host of complications: diabetes, heart disease, kidney failure, leg amputation, cancer and severe musculoskeletal problems. The economic impact of obesity is staggering, with related healthcare costs estimated to be $260 billion annually.
For decades, health experts have pled with Americans to exercise more, eat better, and make lifestyle improvements while urging lawmakers to regulate food and address the “social determinants of health” that lead to excess weight gain. Currently, taxpayers spend billions on government-run nutrition and exercise campaigns, school-based interventions and public food programs. That’s on top of the $190 billion American diet industry, encompassing everything from weight-loss apps to vitamins and supplements. Despite these extensive efforts and expenditures, obesity rates continue to climb, as do the associated consequences, contributing to as many as 500,000 preventable deaths every year.
The Outsized Promise Of GLP-1 Drugs
Studies show that all GLP-1 drugs lead to major weight loss, averaging 15% of a user’s body mass. And when obese individuals combine regular exercise with semaglutide, the active ingredient in Wegovy, they shed an average of 34 pounds.
Beyond weight loss, GLP-1 medications have been shown to reduce the incidence of diabetes and cardiovascular events, prevent kidney failure and potentially improve cognitive function in patients with Alzheimer’s.
It’s important to note that GLP-1 drugs have mild to moderate side effects. They are not a silver bullet. But in conjunction with lifestyle medicine programs, these medications would significantly improve national health—if they were affordable. However, the high prices of weight-loss medications force insurers and employer-sponsored plans to limit coverage, leaving many unable to access these beneficial solutions.
The Current Financial Burden
The cost of providing 100% of obese Americans with GLP-1 medications would surpass $1 trillion a year, even with drug rebates. For perspective, that’s more than twice what Americans spend on all prescription drugs annually. Moreover, that figure dwarfs the $260 billion in projected savings were obesity eradicated.
And because patients who stop taking the medication regain two-thirds of the weight they’ve lost on average, that trillion-dollar annual net cost would persist indefinitely. From the vantage of the U.S. healthcare system, that ongoing expense (an estimated 25% annual bump in total healthcare spending) would strain funding for other vital components of care, including hospitals and clinicians. It would also drive insurance premiums and out-of-pocket costs through the roof.
Understanding The Exorbitant Pricing
A recent report from the office of Sen. Sanders highlighted the stark disparity in global pricing for GLP-1 medications: Americans pay over $1,300 for a 28-day supply of Wegovy while patients pay far less in countries like Denmark ($186), Germany ($137) and the UK ($92).
This is because nearly all national governments, except for the U.S., negotiate the price of prescription medications, rather than allowing drug companies to charge whatever they deem best for their shareholders.
In response to criticisms about its expensive GLP-1 drugs, Novo Nordisk says the prices reflect substantial R&D investments, and that they’ve already declined 40% with rebates. To date, however, the company has neither explained why Americans should bear almost all the financial burden nor provided details on the actual R&D spend. This lack of transparency raises questions about Novo Nordisk’s justifications.
The Hidden Truth
Contrary to what people might assume, these drugs are not expensive to make. According to a research team that included Yale and Harvard scientists, semaglutide can be manufactured for less than $5 per month.
In May 2024, telehealth company Hims & Hers began selling a compounded (pharmacist created) version of the GLP-1 drug semaglutide for $199 per month, about 85% less than the brand-names Wegovy and Ozempic. This reflects a profitable, but more affordable, price point.
Novo Nordisk, by pricing its GLP-1 medications at five to seven times that amount, generated $18 billion in sales last year. With patent protections, those exorbitant profits will continue for at least another decade unless Congress acts.
Hims & Hers is able to sell its version of these patented weight-loss drugs because Congress has authorized the compounding and sale of a patented drug when there is an FDA-determined drug shortage. However, once the GLP-1 shortage is resolved, companies like Hims & Hers will be required to cease production. This will compromise the health of current users and price out many more Americans still struggling to lose weight.
A Creative Solution For The FDA And Congress
A quick fix to address the unaffordability of these life-saving weight loss medications would be for Congress to amend the Food, Drug, and Cosmetic Act and expand the FDA’s definition of “drug shortage.” Whereas “shortage” currently refers only to inadequate supply, a more modern definition would include medications that are unaffordable and therefore inaccessible to millions of people.
This expanded definition would allow compounded versions to remain available at an affordable price, even when weight-loss drug manufacturers increase production. Once market competition brings the price of these drugs under $200 a month (as it is in other nations), the ban on compounded production could be reinstated.
The reason manufacturers like Novo Nordisk price their GLP-1 drugs at $10,000 to $16,000 a year has little to do with R&D, overhead or manufacturing costs. The reason is simple: greed.
Such pricing strategies might be tolerable in other industries, but when the health of tens of millions of Americans is at risk, Congress has an obligation to act. Expanding the definition of “shortage” would break the monopolistic hold of current manufacturers, improve public health, save lives, and incentivize GLP-1 manufacturers to reduce prices. The time for legislative action is now.
