More than 2% of adult patients now take a GLP-1 drug to treat overweight or obesity, according to newly released FAIR Health data, with much of the increase occurring over the past few years.
Among all adult patients, the percentage who had an overweight or obesity diagnosis and were prescribed a GLP-1 drug increased from 0.3% in 2019 to 2.05% in 2024, a relative increase of 586.7%, the white paper found.
The percentage who received an overweight or obesity diagnosis but no type 2 diabetes diagnosis increased 1,960.9%, from 0.03% to 0.67%.
The percentage of all commercially insured adult patients prescribed a GLP-1 drug increased from 0.9% in 2019 to 4% in 2024, a relative increase of 363.7%, with prescriptions for young adults (aged 18-39) increasing 587.8% over that time, from 0.19% to 1.33%. The percentage of adult patients who had bariatric surgery decreased from 0.12% in 2019 to 0.07% in 2024, a relative decrease of 41.8%.
WHAT'S THE IMPACT
For the white paper, FAIR delved into its repository of more than 51 billion commercial healthcare claim records, the nation's largest such database, to examine trends in obesity and GLP-1 drug prescriptions among adult patients from 2019-2024. The study focuses on trends in diagnosis of overweight, obesity and type 2 diabetes, as well as GLP-1 drugs and other obesity treatment options, including bariatric surgery and behavioral health services.
From 2019 to 2024, the percentage of adult patients with a diagnosis of overweight or obesity increased from 10.4% in 2019 to 15.7% in 2024, a relative increase of 50.7%, and authors note that many adult patients who are overweight or obese may not receive a corresponding medical diagnosis.
Among all adult patients prescribed a GLP-1 drug, the percentage who had an overweight or obesity diagnosis and no type 2 diabetes diagnosis increased from 3.7% in 2019 to 16.5% in 2024, a relative increase of 344.4%.
Diagnoses of pancreatitis increased from 0.17% in the year before the first GLP-1 drug prescription to 0.31% in the year after for patients who did not have a type 2 diabetes diagnosis. This was an increase of over 80%, the largest percent increase among the co-occurring diagnoses examined in the study.
Also in that timeframe, among all adult patients with an overweight or obesity diagnosis, the percentage who were prescribed a GLP-1 drug but did not have bariatric surgery increased from 2.5% in 2019 to 11.2% in 2024, a relative increase of 339.5%. And in 2024, more than 80% of patients with an overweight or obesity diagnosis did not receive a GLP-1 prescription, bariatric surgery or behavioral health service. Only 11.2% of such patients received a GLP-1 prescription, 6.3% received behavioral health services, and 0.28% had bariatric surgery.
The use of behavioral health services decreased dramatically for patients prescribed GLP-1 drugs during that time. Out of all patients with an overweight or obesity diagnosis who were prescribed a GLP-1 drug, the percentage of patients who had behavioral health services related to their condition declined from 2019 to 2024. In 2019, 47.2% of such patients had behavioral health services, but in 2024 only 12.4% of patients did, a relative decrease of 73.7%.
THE LARGER TREND
Weight loss drugs such as Wegovy and Zepbound are clinically effective but not cost-effective at their current prices, according to a recent study published in JAMA Health Forum.
Tirzepatide and semaglutide, the generic names for the medications, generate improvements in quality-adjusted life expectancy when they're paired with lifestyle modification, according to the study. But neither medication was cost-effective at the $100,000/quality-adjusted life-year (QALY) benchmark due to their high lifetime treatment costs.
The analysis indicates that a substantial price reduction (30.5% for tirzepatide and 81.9% for semaglutide) would be needed to make the medications more cost-effective.
Expanding Medicare coverage of anti-obesity medicines could increase annual spending by $3.1 billion to $6.1 billion, according to an August Health Affairs study.
The authors forecast that if anti-obesity drugs were covered in 2025, and if 5% of newly eligible patients were prescribed one, annual Part D costs would increase by $3.1 billion annually. If the percentage of patients was doubled to 10%, the price tag could rise by $6.1 billion.
Given that more than 70% of U.S. adults had obesity or were overweight as of 2021, the potential market for these products is large, Health Affairs said.
Health and Human Services Secretary Robert F. Kennedy Jr. has called chronic disease in America an epidemic, blaming ultraprocessed foods for obesity and for other health problems. A 2026 budget proposal released last week states that while one-third of the federal budget is spent on healthcare, life expectancy has declined and chronic disease is on the rise.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.