Average total payments for GLP-1 users without diabetes rose sharply between 2017 and 2022, even as patients personally paid less out of pocket, according to a Northwestern University study published July 16 in the Journal of the American Heart Association.
The findings arrive as GLP-1 spending has already reshaped coverage decisions across payers. Medicare began covering the drugs for the first time in 2026 under Trump-negotiated pricing with Eli Lilly and Novo Nordisk, cutting list prices roughly in half and setting up the $50 monthly copay under the Medicare GLP-1 Bridge program that launched July 1.
Here are five things to know from the study:
- Average total payments per GLP-1 user without diabetes increased 157% between 2017 and 2022, while payments for users with diabetes rose 36%, according to the study.
- Despite rising total costs, average out-of-pocket payments fell 26% among adults without diabetes and 39% among those with diabetes over the same period, as more of the cost shifted to insurers, employers and government programs.
- GLP-1 use increased 643% among adults without diabetes and 230% among those with diabetes from 2017 to 2022, based on Medical Expenditure Panel Survey data representing more than 20 million U.S. adults.
- Semaglutide was the dominant GLP-1 drug by 2022, accounting for 65% of use among adults without diabetes and 54% among those with diabetes. The analysis predates tirzepatide’s approval for weight loss, so it isn’t reflected in the data.
- Study authors said rising total costs could push up premiums, taxes and insurance restrictions for people regardless of whether they take a GLP-1, a concern they said has grown more urgent since Medicare launched its temporary $50 monthly copay program for GLP-1s this month.
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