The Trump administration introduced plans to lower obesity drug costs for Medicaid and Medicare, but commercial insurance coverage of GLP-1s remains a concern.
“There is some speculation that this initiative will help create downward pressure for drug manufacturers to lower costs for commercial plans,” Bruce Rogen, MD, chief medical officer of the Cleveland Clinic Employee Health Plan and chair of the Cleveland Clinic Quality Alliance, told Becker’s.
Last month, GoodRx Research compiled insights on prescription insurance coverage from Managed Markets Insight and Technology, comparing data, as of November 2024 and August 2025, to assess the coverage landscape for GIPs and GLP-1s.
Here are five things to note:
1. Restrictions, such as prior authorization or step therapy, are pronounced. Over 88% of people face restrictions on insurance coverage for Wegovy, Zepbound and Saxenda.
2. Over 6 million people gained commercial insurance coverage for Wegovy in 2025, but restrictions persist. This jump follows a change in CVS Caremark’s formulary, which also affected Zepbound.
3. Since 2024, 62 million more people have no insurance coverage for Zepbound, with the total now reaching 97 million people.
4. The availability of generic liraglutide has led to drops in commercial insurance coverage for Victoza and Saxenda in 2025. The number of people without coverage for these brand-name drugs has increased by 120% and 49%, respectively.
5. This year, nearly 10% of people with commercial insurance lack coverage for any GIP and GLP-1 agonists that could be prescribed for weight loss.
