Price and Value Out of Whack for Wegovy and Zepbound

A new analysis in JAMA Health Forum yesterday shines a harsh light on pricing for new obesity medicines. In a rigorous econometric analysis, researchers found that new and highly effective medicines for obesity – Wegovy (semaglutide) and Zepbound (tirzepatide) – are both overpriced. They also found that the price and value of Wegovy was out of whack in comparison to Zepbound.

The authors of this analysis concluded that both of these new drugs offer significant lifetime health gains over older obesity drugs. But the current net prices are too high for them to be cost-effective.

Further, they found that net prices for Wegovy were especially misaligned with the value it offers. Though they estimated its lifetime health benefits to be less than Zepbound, the net prices actually paid for it are higher.

Less value for a higher price simply does not add up in the eyes of these health economists.

Older Drugs, Better Value for Now

Note that these conclusions come from a comparison of value to two older obesity medicines: phentermine-topiramate and naltrexone-bupropion. Those combination drugs offer less benefits over the lifetime of an average person taking them, but they are much less expensive. In the estimates of net prices for this analysis, Wegovy was roughly 20 times more expensive than naltrexone-bupropion. In comparison to Zepbound, the Wegovy net price was 35% higher than Zepbound.

Something’s Got to Give

This makes two things very clear to us. First, the pressure to bring the price of Wegovy and Zepbound into line with their value will be intense. But in the process, patients are caught in the crossfire between payers and makers of these remarkable drugs. The result is substantial harm to marginalized patient groups denied access to care. The authors make this point:

“Most state Medicaid programs and Medicare do not cover antiobesity medications, and private insurance plans restrict access by requiring prior authorization. Consequently, the lack of additional discounts and inadequate coverage through state, federal, and private insurance programs leave many patients unable to afford these medications, resulting in higher premiums and cost sharing. These high net prices will likely exacerbate obesity disparities, disproportionately affecting racial and ethnic groups with unequal health care access.”

Second, it seems especially clear that the current pricing for Wegovy is unsustainable. By this analysis, Novo Nordisk is getting a 35% net premium over a more effective alternative.

We seriously doubt that people will keep paying more for less. So Wegovy prices, in particular, seem destined to come down substantially. Patents on the product begin expiring in 2026.

Click here for the paper in JAMA Health Forum, here, here, and here for further perspective.

The Gold Weigher, painting by Salomon Koninck / WikiArt

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March 15, 2025