- One in eight American adults have used a GLP-1 agonist.
- This class of drugs are prescribed for weight loss, to treat diabetes, and to reduce the risk of heart attack and stroke in adults with heart disease.
- Use of GLP-1 drugs solely for weight loss was higher among younger adults than those 65 years or older.
One in eight or about 13% of American adults have used a GLP-1 agonist, a class of drugs prescribed for weight loss, to treat diabetes, or to reduce the risk of heart attack and stroke in adults with heart disease, a new survey found.
Half of those people or about 6% report they are currently taking one of these drugs, which includes Novo Nordisk’s Ozempic and Wegovy, and Eli Lilly’s Mounjaro and Zepbound, among others.
“I suspect a large driver of this drop-off [of people currently using the drugs] is cost,” said Beverly Tchang, MD, endocrinologist and Ro advisor. More than 50% of those surveyed identified cost or insurance coverage as their biggest concern in KFF’s survey.”
The latest KFF Health Tracking Poll, conducted April 23 to May 1, also found higher rates of GLP-1 drug use among people whose doctor told them they have diabetes (43%) or heart disease (26%).
In addition, higher rates were seen among people whose doctor told them they have obesity or are overweight with 22% of those people taking the drug.
“The majority of people who have taken a GLP-1 drug have taken it for diabetes mellitus and now heart disease,” said Katrina Mattingly, MD, chief medical officer of Options Medical Weight Loss.
“However, “[these drugs] are still being grossly underutilized for overweight and obese populations, which is a major risk factor for the development of diabetes mellitus and cardiovascular disease (CVD),” she told Healthline. “Once people get the weight off, the risk for diabetes and CVD, and the complications from those conditions, goes down with it.”
Differences were also seen among racial and ethnic groups. In the survey, nearly two in 10 Black adults (18%) reported ever taking a GLP-1 drug, compared to one in 10 white adults (10%) and around one in eight Hispanic adults (13%).
”Black Americans typically suffer from disproportionate rates of chronic disease, so it makes sense there would be more utilization in this population for chronic disease management,” said Mattingly.
However, “it would be interesting to see what the use for weight loss versus chronic disease would be across demographics,” she said. “As we know, minority populations do not always have access to the same quality healthcare or the financial capacity to afford these powerful drugs.”
GLP-1 drugs like Ozempic can be too expensive for many patients
Around 62% of people who have taken GLP-1 drugs did so as a treatment for diabetes, heart disease or another chronic condition, with 38% saying they did so mainly to lose weight.
The fact that these drugs are not utilized for weight loss may be because health insurers may be less likely to cover the cost of high-priced GLP-1s if they are prescribed solely to help with losing weight. These restrictions leave people to pay out of pocket for all or most of the cost of the drug.
The list prices for GLP-1 drugs range from around $900 to $1,400 per month. This is the price before insurance coverage, coupons or rebates.
Around half of adults or 54% who have taken a GLP-1 agonist reported having difficulty affording the medication, with 22% saying it was “very difficult,” according to the KFF poll.
Even 53% of those people with some insurance coverage for GLP-1 drugs found it difficult to afford these medications.
“The cost of GLP-1 medications for uninsured patients and those that get caught in the coverage gap is not sustainable for the average American who cannot even afford a $400 emergency expense,” said Mattingly.
“[GLP-1] drugs should be seen as a necessity and not a luxury,” she said. “I would like to see the costs associated with GLP-1 medications eventually hit the same level of affordability as generic blood pressure medications.”
What to know about Medicare and GLP-1s
The KFF survey also found that younger adults are more likely than older adults to report taking GLP-1 drugs just for weight loss.
For 18- to 29-years, 7% used a GLP-1 drug for weight loss, and for 30- to 49-year-olds, the rate was 6%.
In comparison, among adults ages 65 and older, 8% say they have taken a GLP-1 drug for diabetes, heart disease or another chronic condition. However, only 1% report using a GLP-1 drug to lose weight.
”Younger adults often have the discretionary cash to spend on these drugs for weight loss, which many times are not covered by insurance,” said Mattingly. “But adults 65 and older are more likely to be retired, on a fixed income and the recipients of Medicare benefits.”
Medicare, by law, cannot cover the cost of GLP-1 drugs when prescribed solely for weight loss.
“This is why we’re seeing it more for chronic conditions — which supplemental insurance may be helping to cover — versus solely for weight loss,” said Mattingly.
However, there is strong public support for broader coverage of GLP-1 drugs by Medicare.
About 61% of adults say they think Medicare should cover the cost of GLP-1 drugs for weight loss when people are overweight. The rates were similar for all age groups.
In contrast, higher numbers of Democrats (66%) and Independents (63%) say Medicare should cover GLP-1 drugs for weight loss, compared to Republicans (55%).
“You rarely see Democrats and Republicans agree on an issue, so it’s particularly impactful that majorities agree on this,” Tchang told Healthline. “Medicare should cover GLP1s for obesity.”
What if the use of GLP-1s keeps rising?
Sue Decotiis, MD, a NYC-based medical weight loss doctor, expects more Americans will start taking GLP-1s for weight loss, especially now that Zepbound and Wegovy are FDA-approved for that use. She expects more doctors will also feel comfortable prescribing these medications solely for weight loss.
However, she thinks cost will remain an issue for some time. Tchang agrees, saying that the use of these drugs will be limited by “barriers to access created by insurance.”
Mattingly hopes expanded insurance coverage will eventually allow more people to take advantage of these medications.
“Insurance companies will realize it’s cheaper to treat obesity … rather than pay for chronic conditions stemming from being overweight or suffering from obesity,” she said, such as strokes, heart attacks, joint replacements, sleep apnea, depression, and others.
With increased treatment of obesity, “we would expect that healthcare expenditures should eventually go down over the long term,” said Mattingly, “lowering premiums and out-of-pocket costs for all.”
Tchang agrees.
“Medicare is uniquely positioned to be the first to experience the compounding benefits of covering GLP-1s for obesity at age 65,” she said. “Over the subsequent 20-plus years, we’d be able to discover all of the heart surgeries, knee surgeries and hospitalizations that were avoided — and that the system never had to pay for — because of GLP-1 coverage.”
However, the large number of GLP-1 drug prescriptions has meant that there have been major shortages of some of these drugs. And these shortages may get worse, expects Decotiis.
Shortages can affect patients in multiple ways, said Decotiis. First, patients may not be able to take their medication regularly because they can’t find it at a pharmacy. They might also not be able to find the right dose of the drug, even if the pharmacy has other doses in stock.
“[These shortages] are very upsetting for patients,” she told Healthline. “And the doctors are also drawn into it, because we get the phone calls from patients.”
Takeaway
A KFF Health Tracking Poll found that one in eight American adults had used a GLP-1 agonist, with half of those people still taking the medication.
These drugs include Novo Nordisk’s Ozempic and Wegovy, and Eli Lilly’s Mounjaro and Zepbound, among others. They are prescribed to help people lose weight, to treat diabetes, or to reduce the risk of cardiovascular disease in adults with heart disease.
Cost was a big issue among people who have used a GLP-1 drug, even among those whose insurance covers part of the medication. At this time, Medicare does not cover GLP-1s when prescribed solely for weight loss.
