GLP-1s are driving traditional drug spending in the U.S. to unprecedented levels, which now outpaces specialty drug spending for the first time, according to a March 25 report from Evernorth.
The report is based on data collected from scientific literature, pharmacy claims, industry reports, and surveys of pharmacists, providers, health plan executives, large employers, and individual consumers. Claims analysis included 27.3 million members with commercial insurance coverage.
“Looking ahead, GLP-1 therapies will continue expanding beyond obesity and diabetes treatment to other chronic conditions, accelerating their widespread adoption,” the researchers wrote. “While these advancements offer transformative potential in addressing the chronic disease epidemic, they also bring significant challenges raising critical questions about affordability, accessibility and long-term sustainability.”
Seven key findings:
1. U.S. prescription drug spending hit $723 billion in 2023. Among commercial health plans, spending grew 8.9% in 2024, driven by more chronic conditions, inflation and expanded indications.
2. The annual growth rate of semaglutide spending increased from 2.1% in 2021 to 12.8% in 2024.
3. In 2024, weight management drugs accounted for 46.8% of the total increase in drug spend and equated to 6.7% of total drug costs. GLP-1s for weight loss specifically saw a 210.2% increase in 2023 and 148.7% in 2024.
4. Twenty-four percent of consumers are currently considering GLP-1s and 65% of providers are willing to prescribe them. GLP-1 utilization for weight loss is projected to increase 73.1% in 2025.
5. For weight loss, 59% of health plans say they fully cover GLP-1s, while 22% of employers say the same. Among health plans, 49% require prior authorization and 41% require ongoing mental/behavioral health support to manage usage and ensure compliance.
6. Gen Alpha (14 years and under) are leading the overall increase in GLP-1 utilization, growing 84.6% from 2023 to 2024, followed by Gen Z (15 to 28 years) at 67.8%, and millennials (29 to 43 years) at 47.7%.
7. Evernorth research previously found that more than 50% of patients using GLP-1s for weight loss stopped treatment within 12 months, with the top five reasons being side effects and safety concerns (43.7%), the patient felt GLP-1s were no longer needed (40.1%), financial and insurance barriers (30.9%), adherence challenges (15.3%), and provider-driven discontinuation (13.1%).
