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While weight-loss drugs like Zepbound (LLY+1.44%) and Wegovy (NVO+4.34%) offer significant health benefits, their high costs make them economically inefficient under current U.S. healthcare standards, according to a new study published Friday in JAMA Health Forum.
Researchers analyzed national survey data to assess the long-term impact of four anti-obesity medications, including tirzepatide and semaglutide — the active ingredients in Zepbound and Wegovy, respectively. They found that these drugs could help prevent obesity-related complications such as heart disease and diabetes. However, their high price tags — $12,648 per year for tirzepatide and $13,618 per year for semaglutide — exceed the typical cost-effectiveness threshold of $100,000 to $150,000 per quality-adjusted life-year (QALY).
QALY is a standard benchmark in healthcare used to evaluate whether a medical treatment provides good value for its cost, essentially how much a healthcare system or insurance provider is generally willing to pay for each additional QALY or year of perfect health gained under a treatment. In the U.S., treatments are generally considered cost-effective if they fall below the $100,000–$150,000 per QALY range.
To meet that threshold, the study found, tirzepatide’s price would need to drop by 30.5%, while semaglutide would require an 81.9% reduction.
“Efforts to reduce the net prices of new anti-obesity medications are essential to ensure equitable access to highly effective anti-obesity medications,” the study authors wrote.
The findings come as the Centers for Medicare & Medicaid Services (CMS) moves forward with efforts to lower drug costs. Earlier this year, CMS announced it had selected 15 additional drugs for its second round of price negotiations, including Novo Nordisk’s Ozempic and Wegovy. The new lower Medicare prices are set to take effect in 2027.
For their part Novo Nordisk and Eli Lilly — the maker of Zepbound — have both launched direct-to-consumer pharmacies that offer the drugs at lower prices for patients that pay without insurance.