Zepbound Faces Market Access, Supply Challenges

  • Nov 22, 2023

    Zepbound (tirzepatide), Eli Lilly and Co.’s latest glucagon-like peptide 1 (GLP-1) agonist product and Lilly's first entrant in that category to be marketed only as a weight loss drug, garnered FDA approval on Nov. 8. The approval intensified already fierce public interest in using GLP-1s for weight loss — which could be bad news for payers, especially commercial plan sponsors, who were already concerned before Zepbound’s approval that the high cost and broad appeal of the drugs will cause premiums to spike.

    A recent WTW survey found that 38% of employer-backed health plans cover weight loss drugs, while 22% are considering adding coverage. Mercer found that 42% of large employers cover GLP-1 drugs for weight loss. Brokers and employer plan sponsor trade groups have identified burgeoning GLP-1 utilization as a possible reason for future premium hikes.

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  • Peter Johnson

    Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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