The first phase of the GLP-1 boom was defined by shortages and brand-name manufacturers sparring with compounding pharmacies. The next phase will be marked by Medicare coverage expansions and new GLP-1 pills for weight loss — two developments expected to further accelerate usage.
In 2025, the U.S. spent $131.9 billion on GLP-1 medications, accounting for 14% of all prescription drug spending.
Eli Lilly nearly tripled year-over-year profit largely because of its GLP-1 portfolio, according to its first-quarter financial results published April 30. The Indianapolis-based company recorded $19.8 billion in worldwide revenue in the first quarter of 2026. Eli Lilly’s GLP-1 medications Mounjaro and Zepbound drove 65% of this revenue.
This revenue growth does not account for the launch of Foundayo, Eli Lilly’s newly approved GLP-1 pill for weight loss. The FDA approved the pill April 1, meaning its commercial impact will begin appearing in second-quarter results.
With nearly 1 in 8 U.S. adults receiving a GLP-1 prescription, plus another predicted surge in demand due to new GLP-1 pills for weight loss, some health systems are strategizing how to establish safe prescribing boundaries for GLP-1s and support patients taking these medications.
A brief history
In fall 2022, unprompted endorsements from celebrities and social media buzz signaled the beginning of the GLP-1 boom. Novo Nordisk’s Ozempic and Wegovy, and Eli Lilly’s Mounjaro and Zepbound, experienced a monthslong shortage due to the sudden spike in demand.
By January 2023, “everybody is either on it or asking how to get on it,” a New York City-based dermatologist told The New York Times. “We haven’t seen a prescription drug with this much cocktail and dinner chatter since Viagra came to the market.”
During the supply shortages, compounding pharmacies and telehealth companies increasingly jumped into the GLP-1 market — to the dismay of Eli Lilly and Novo Nordisk. In April, the FDA proposed restricting compounding pharmacies from manufacturing active pharmaceutical ingredients for GLP-1s, including semaglutide and tirzepatide.
Both drugmakers operate direct-to-consumer platforms, which provide discounts to cash-paying patients. Eli Lilly is also offering its newly approved weight loss GLP-1 pill, Foundayo, through GoodRx, telehealth firm Ro and same-day delivery with Amazon Pharmacy. Novo Nordisk has launched a 12-month Wegovy subscription program.
What’s coming
In July, Medicare will cover — for the first time — GLP-1 prescriptions for overweight or obesity. CMS previously only covered these medications for indications such as Type 2 diabetes.
Following the most-favored-nation pricing agreements between drugmakers and the Trump administration, the White House announced the Medicare coverage allowance in November. The monthly Medicare price for Ozempic, Wegovy, Mounjaro and Zepbound will be $245, with a $50 copay.
A Biden administration-era law, the Inflation Reduction Act, granted CMS the authority to negotiate drug prices with manufacturers. On Jan. 1, 2027, the CMS-negotiated prices for Ozempic, Wegovy and Rybelsus will go into effect, capping the price of drugs at $274 per month, down from the 2024 list price of $959.
With the recent launch of oral GLP-1 medications approved for obesity or overweight conditions, plus other potential approvals and uses that could broaden the patient population, demand is expected to accelerate further and intensify cost, access and care delivery challenges for health systems and payers.
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