In 2005, the first glucagon-like peptide-1, or GLP-1, designed to treat Type 2 diabetes (T2DM) was officially approved by the FDA. Since then, several new and improved GLP-1s with reduced dosing frequency have allowed for improved adherence and efficacy. While GLP-1 medications effectively control A1C, a common biomarker used to measure blood sugar levels in T2DM patients, these medications can also lead to significant weight loss, allowing pharmaceutical manufacturers to market them for weight management.
On December 5th, 2023, Zepbound (tirzepatide), a dual mechanism GLP-1/GIP, or glucose-dependent insulinotropic polypeptide, medication was approved for chronic weight management and made available at pharmacies across the U.S. Tirzepatide was initially approved on May 13th, 2022, as Mounjaro for T2DM. Mounjaro1 and Zepbound both share the same active ingredient and strengths. Novo Nordisk followed a similar process to market Ozempic (indicated for T2DM) under the label name Wegovy for weight management, despite having the same active ingredient of semaglutide. The list price of Zepbound is $1,059.87, approximately 20% lower than Wegovy.
Notable GLP-1s on the Market
| Product Name | Indication | Manufacturer | Cost (WAC/Year) | Weight Loss |
|---|---|---|---|---|
| Ozempic (semaglutide) | Type 2 diabetes | Novo Nordisk | $12,165 | 6.4% |
| Wegovy (semaglutide) | Obesity | Novo Nordisk | $17,537 | 16% |
| Mounjaro (tirzepatide) | Type 2 diabetes | Lilly | $13,300 | 13% |
| Zepbound (tirzepatide) | Obesity | Lilly | $13,778 | 20.9% |
| Victoza (liraglutide) | Type 2 diabetes | Novo Nordisk | $13,588 | 6% |
| Saxenda (liraglutide) | Obesity | Novo Nordisk | $16,413 | 7.4% |
| Trulicity (dulaglutide) | Type 2 diabetes | Lilly | $12,101 | 4.6% |
The chart above highlights major GLP-1s with significant market share but does not encompass all existing GLP-1 medications.
As more patients look to GLP-1s as a form of weight management, pharmaceutical company, Eli Lilly, offers copay card assistance, where patients without obesity coverage may pay $550 for a one-month supply of Zepbound. Patients with obesity coverage may be eligible to pay as low as $25 for a one-month or three-month prescription. Eli Lilly later introduced LillyDirect, a website allowing providers to prescribe GLP-1 medications for weight loss through telehealth services. For patients prescribed Zepbound, Eli Lilly allows at-home delivery.
Currently, there are only three GLP-1s that have an indication for weight loss: Saxenda (liraglutide), Wegovy (semaglutide) and Zepbound (tirzepatide). Out of the three, Zepbound currently provides the highest percentage of weight loss at approximately 20.9% with the lowest rates of discontinuation due to side effects. With a unique dual mechanism, the side effects seen in patients taking Zepbound appear to be less severe compared to other weight loss products on the market, which helps to improve tolerability and reduce discontinuation rates. Common side effects include decreased appetite, diarrhea and nausea.
As of January 1, 2024, Employers Health pharmacy benefit providers have placed Zepbound on a new-to-market block, pending a decision on its formulary inclusion. The complex and fast-paced world of GLP-1s can be confusing and even frustrating to understand, but our team is readily available to help. We will continue to monitor and share updates on emerging obesity treatments as they become available. Stay up-to-date with our employee benefits articles, podcast and email newsletter to receive the latest news.
