Rise of GLP-1s raises long-term affordability questions

• For Journalists
• News Releases
• Latest Releases
• News Release

Rise of GLP-1s raises long-term affordability questions

Average total payments per user more than doubled for adults without diabetes from 2017 to 2022, study found

EMBARGOED UNTIL 10 A.M. ET ON THURSDAY, JULY 16, 2026

• GLP-1 use increased 643% among adults without diabetes between 2017 and 2022
• Average total payments per user in that group increased 157%
• Findings point to questions about the long-term affordability of GLP-1s and who ultimately pays for them
  

CHICAGO - As use of GLP-1s surged across the U.S., average total payments per user also climbed sharply, according to a new Northwestern University study that analyzed national trends in GLP-1 use and spending between 2017 and 2022. These total payments included out-of-pocket costs paid by patients as well as payments from insurers, employers and government programs.

The study authors say the findings raise questions about the long-term affordability of drugs that many patients may take for years or even decades. Those questions became even more relevant earlier this month when Medicare launched a temporary program that gives millions of eligible seniors potential access to GLP-1s for a flat $50 monthly copayment.

"Higher total costs of GLP-1 drugs might drive up taxes and increase insurance premium payments both for people taking GLP-1s and those not," said study first author Dr. Michael Hammond, a recent graduate of the internal medicine residency program at Northwestern's McGaw Medical Center.

The study will publish on Thursday (July 16) in the Journal of the American Heart Association.

The findings

Using data from the Medical Expenditure Panel Survey (MEPS), Northwestern scientists analyzed usage and spending trends for nearly 1,900 participants who reported using a GLP-1 drug between 2017 and 2022. The authors estimate that these participants were representative of more than 20 million U.S. adults.

The study period coincided with semaglutide's FDA approvals for Type 2 diabetes in 2017 (Ozempic) and weight management in 2021 (Wegovy). Tirzepatide (Zepbound, Mounjaro) was approved for weight loss after the study period and was not included in the analysis.

For the spending trends, the research team looked at total payments (from patients, insurance, employers, Medicare, Medicaid and other programs) and out-of-pocket payments made directly by patients and their families.

The scientists found that between 2017 and 2022:

• Average total payments per patient increased 157% among adults without diabetes and 36% among those with diabetes
• Despite rising total payments, average out-of-pocket payments per patient declined 26% among adults without diabetes and 39% among those with diabetes
• GLP-1 use increased 643% among adults without diabetes and 230% among adults with diabetes
• Semaglutide became the dominant GLP-1 drug by 2022, accounting for 54% of usage among adults with diabetes and 65% among adults without diabetes

The authors note that while this study only used data through 2022, Medicare and Medicaid spending on GLP-1s has continued to surge in recent years.

Who foots the bill?

As spending on GLP-1s continues to grow, the discussion about who foots the bill extends beyond those taking the drugs, the Northwestern scientists said.

"On the commercial side, employers and insurers facing higher drug spending tend to pass it through in the form of higher premiums, higher deductibles or tighter rules," said study senior author Xiaoning Huang, assistant professor of medicine in the division of cardiology at Northwestern University Feinberg School of Medicine.

"On the public side, it shows up as higher Medicare and Medicaid spending funded by taxpayers, and some state Medicaid programs have started dropping coverage under budget pressure," Huang added. "So, the bill ultimately lands on premium payers, taxpayers and, in some cases, on patients who lose coverage or face new hurdles."

Huang says more studies are needed to evaluate policies and strategies that can reduce overall and out-of-pocket payments for GLP-1s

Other Northwestern University authors include Lucia Petito and Dr. Sadiya Khan.

The study is titled, "Trends in Usage and Payments for Glucagon-Like Peptide 1 Receptor Agonists in the United States, 2017 to 2022: A Nationally Representative Repeated Cross-Sectional Study." It was funded by the National Institutes of Health (grant 1R01HL180694-­ 01).