Wegovy and Zepbound, two popular weight loss GLP-1 medications, would remain cost-effective at a higher price, according to an Oct. 29 revised report from the Institute for Clinical and Economic Review.
The estimated annual net price for Eli Lilly’s Zepbound annually costs $7,973, while Novo Nordisk’s Wegovy is $6,829, according to the ICER, a nonprofit organization that evaluates the cost-efficacy ratio of therapies and diagnostic tests.
The institute said both drugs would remain cost-effective at higher prices, calculating a health benefit price benchmark between $9,100 and $12,500 for Wegovy and between $11,500 and $15,700 for Zepbound.
“Despite the high cost-effectiveness of these treatments, there are serious affordability concerns,” the organization said in a statement. “ICER estimates that fewer than 1% of eligible patients could be treated at current and assumed net prices before crossing the ICER budget impact threshold of $880 million annually.”
In its review, the institute assessed the comparative clinical effectiveness and value of Wegovy (semaglutide) and Zepbound (tirzepatide) for treating obesity.
Researchers examined injectable semaglutide, which is approved for obesity, cardiovascular disease and liver disease; oral semaglutide, an experimental formulation undergoing FDA review; and injectable tirzepatide, which is indicated for obesity and obstructive sleep apnea.
Compared to lifestyle modifications such as physician activity and nutrition therapy, the ICER assigned an “A” rating for all three GLP-1 medications. In a head-to-head comparison of Zepbound and Wegovy, Zepbound resulted in greater weight loss on average (-20.2% versus -13.7%, respectively).
However, whether Zepbound provides greater health benefits beyond weight loss compared to Wegovy is “promising but inconclusive,” the report said.
ICER gave a “C” rating to oral semaglutide, adding the drug candidate was “comparable [to] or worse” than the injectable version when comparing the two formulations for weight loss and cardiovascular benefit.
Eli Lilly reported Oct. 30 that global revenue from Zepbound and Mounjaro, a diabetes drug with the same active ingredient, collectively earned the drugmaker approximately $10.1 billion in the third quarter of 2025. Together, the two drugs outpaced cancer drug Keytruda, which earned Merck $8.1 billion in the same quarter.
For years, Keytruda had held the title as the most lucrative medication sold in the U.S.
Access the ICER’s initial report on Wegovy and Zepbound here.
