A whopping one in eight U.S. adults have taken GLP-1 drugs like Wegovy and Ozempic for weight loss and related conditions. The drugs’ popularity and efficacy have sparked a prescription-writing frenzy in recent years, leaving both medications on the Food and Drug Administration’s drug shortage list since May 2023.
But even when supply rebounds, access will remain out of reach for the majority of Americans. That’s because brand-name versions range from $11,000 to $16,000 a year, prices that are unaffordable for most people.
Fortunately, Congress can implement a straightforward solution to make these drugs affordable, thereby improving the nation’s financial and physical health. Before explaining that strategy, here’s why our nation needs effective, affordable and available weight-loss medication.
Around 42 percent of American adults are obese, putting them at dramatically elevated risk for a host of complications: diabetes, heart disease, kidney failure, leg amputation and severe musculoskeletal problems. The economic impact of obesity is staggering, with related health care costs estimated to be $260 billion annually.
Studies show that all GLP-1 drugs lead to major weight loss, averaging 15 percent of a user’s body mass. And when obese individuals combine regular exercise with semaglutide, the active ingredient in Wegovy, they shed an average of 34 pounds.
The cost of providing 100 percent of obese Americans with GLP-1 medications would surpass $1 trillion a year, even with drug rebates. For perspective, that’s more than twice what Americans spend on all prescription drugs annually.
A recent report from Sen. Bernie Sanders’ office highlighted the stark disparity in global pricing for GLP-1 medications: Americans pay over $1,300 for a 28-day supply of Wegovy while patients pay far less in countries like Denmark ($186), Germany ($137) and the United Kingdom ($92).
This is because nearly all national governments, except for the United States, negotiate the price of prescription medications, rather than allowing drug companies to charge whatever they deem best for their shareholders.
These drugs are not expensive to make. A team of Yale and Harvard scientists determined that semaglutide can be manufactured for less than $5 per month.
In May 2024, telehealth company Hims & Hers began selling a compounded (pharmacist created) version of the GLP-1 drug semaglutide for $199 per month, about 85 percent less than the brand names Wegovy and Ozempic. This reflects a profitable, but more appropriate, price point.
Hims & Hers can sell its version of these patented weight-loss drugs because Congress has authorized the compounding and sale of a patented drug when there is an FDA-determined drug shortage. However, once the GLP-1 shortage is resolved, companies like Hims & Hers will be required to cease production. This will compromise the health of current users and price out many more Americans still struggling to lose weight.
Congress can make these lifesaving weight loss medications affordable by expanding the FDA’s definition of “drug shortage.” Whereas “shortage” currently refers only to inadequate supply, a more modern definition would include medications that are unaffordable. By amending the Food, Drug, and Cosmetic Act, this expanded definition would allow compounded versions to remain available at a reasonable price, even when weight-loss drug manufacturers increase production.
The reason manufacturers price GLP-1s at $10,000 to $16,000 a year has little to do with research and development, overhead, or manufacturing costs. The reason is simple: greed.
When the health of tens of millions of Americans is at risk, Congress has an obligation to act. Expanding the definition of “shortage” would break the monopolistic hold of current manufacturers, improve public health, save lives and incentivize GLP-1 manufacturers to reduce prices. The time for legislative action is now.
Robert Pearl teaches at the Stanford University School of Medicine and the Stanford Graduate School of Business. He wrote this for The Fulcrum.
