WSJ Your Money Briefing - Making Sense of Weight-Loss Drugs’ Cost and Coverage

Episode Date: June 4, 2025

GLP-1s like Ozempic and Wegovy are no longer in short supply, yet they still can cost more than $1,000 a month out of pocket. Wall Street Journal contributor Cheryl Winokur Munk joins host Callum Borc...hers to dig into why some people pay much more for weight-loss drugs than others.  Sign up for the WSJ's free Markets A.M. newsletter.  Learn more about your ad choices. Visit megaphone.fm/adchoices

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Starting point is 00:00:35 I'm Callum Borschers for The Wall Street Journal. It's a confusing time to shop for GLP-1 weight loss drugs like Ozempic and Wigovie. The insurance plan you expected to cover your prescription might not pick up the tab after all. At least there's no longer a shortage of these popular medications. The law of supply and demand means prices will come down, right? So much when it comes to the cost of GLP-1 drugs is it depends, and that's very frustrating for consumers, especially
Starting point is 00:01:05 for people who really want access to these drugs and don't have the means to get the access. We'll try to make sense of the GLP-1 market with WSJ contributor Cheryl Winokur-Munk. That's coming right up after the break. The new BMO VI Porter MasterCard is your ticket to more. More perks. More points. More flights. More of all the things you want in a travel rewards card.
Starting point is 00:01:39 And then some. Get your ticket to more with the new BMO VI Porter MasterCard and get up to $2,400 in value in your first 13 months. Terms and conditions apply. Visit BMO.com slash VI Porter to learn more. GLP-1 weight loss drugs have helped millions of people treat obesity and related conditions like diabetes, but name-brand medications like Ozempic and Wagovi can cost more than a thousand dollars a month if you're paying out of pocket. There are ways to reduce your expenses, if you know the playbook.
Starting point is 00:02:18 Wall Street Journal contributor Cheryl Winokur-Munk is here to clue us in. Cheryl, why are these drugs so expensive in the first place? Well, for a couple of reasons. So first, newer drugs tend to cost more because of the upfront research and development. There are also patent laws that limit competition and keep prices higher. So if no one else is making a particular drug and it's on large demand, it becomes an economics issue. Also, the US, unlike some other countries that routinely negotiate drug prices,
Starting point is 00:02:46 hasn't stepped in to do so. So that's why they're more expensive. Cheryl, the FDA says a drug shortage that lasted more than two years is over. That seems good on its face, but there's a catch, right? Online pharmacies like Hims and Hers Health could lose the ability to sell knockoff GLP ones at discounted prices
Starting point is 00:03:03 now that there's enough of the real deal to go around. What does all this mean for patients' bills? Well, it depends. Even though the drugs may no longer be available through certain vendors, the manufacturers are aware of the demand and the need for these drugs, and in some cases are trying to offer lower prices.
Starting point is 00:03:20 Also, more employers are at least considering coverage for weight loss, and this is likely to increase as we get more long-term data on the safety of GLP-1 drugs. So you may have to pay more in the short term, but there may be a light at the end of the tunnel. Well, help me bargain hunt in the short run. Could I get a better price if I go straight to the manufacturer? And what if I'm willing to forego those sleek dosing pens we see in the commercials and just use an old-school vial and syringe?
Starting point is 00:03:46 So much when it comes to the cost of GLP-1 drugs is it depends and that's very frustrating for consumers Especially for people who really want access to these drugs and don't have the means to get the access So it makes sense for people to look at what the manufacturers have to offer and see the dosages and the means of delivery That work for them. It's also good to keep checking back with their insurance company to see if anything's changed because the coverage does change. They may even consider petitioning the insurance to cover
Starting point is 00:04:16 if the insurance doesn't cover it. There are also price comparison sites that consumers can use, sites such as GLP Winner, and you can compare prices of brand-name GLP-1 drugs and get more information on some of the potential options. I suppose the ideal scenario would be for my employer-sponsored health insurance to pay for my weight loss drug. Business leaders I've talked to say they hate covering GLP-1s because they're often a net loss, even though leaner employees have fewer health problems.
Starting point is 00:04:42 How common is it for corporate insurance to cover these medications? I've seen figures suggesting the coverage levels are higher, but conservatively a survey from the International Foundation of Employee Benefit Plans of employer coverage in 2025 found that 36% of employers in the US provide their workers with coverage for GLP-1 drugs to treat weight loss. And meanwhile, 55% provide coverage for the treatment of diabetes only. I think you are going to see that go up over time, but for now, this is roughly where we're at.
Starting point is 00:05:12 What should would-be users know about any additional conditions their employers might place on them? For example, saying you have to also do this weight loss course in addition to the GLP-1. Well, that's the thing, because these drugs are so expensive for employers, that they do put these conditions on them. So it's not a one size fits all.
Starting point is 00:05:31 You're going to really have to check with your employer to see what conditions, if any, there are for getting these drugs covered for what you need it for. And what's the status of Medicare coverage? So Medicare has said that Part D plans, the part of Medicare that used to cover prescription drugs, have options to cover weight loss drugs like Wicovy if it's used for cardiovascular
Starting point is 00:05:51 conditions. That's not the answer many people were hoping for, given that a Biden administration proposal would have provided coverage of weight loss drugs to about 3.4 million Medicare beneficiaries who are obese. But proponents are hoping that Medicare plans will cover these drugs more widely in the future. It's a remain to be seen situation. Now with any expensive drug there's always the promise of a cheaper generic eventually hitting the market when the patents
Starting point is 00:06:16 expire. How far off is that light at the end of the tunnel though? A ways off unfortunately for people who are hoping to see cheaper generics now. These patents don't expire for a number of years, and even then, when the drug manufacturers change it slightly, they can apply for another patent, and this could go on for quite a while. But we'll see. President Trump recently signed a sweeping executive order with the goal of cutting prescription drug costs in the US. And GLP ones haven't been singled out, but they're likely to be among those targeted for
Starting point is 00:06:47 price cuts. And he's made comments before decrying the high cost of these drugs. So as I said, we'll see. That's WSJ contributor Cheryl Winokur Monk. And that's it for your money briefing. This episode was produced by Zoe Culkin with supervising producer Melanie Roy. I'm Callum Borschers for The Wall Street Journal. Thanks for listening!

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