GLP-1s can save health system money if priced below $350 a month: analysis
CVS Health claims that employers and health plan sponsors could potentially break even on GLP-1 drugs if the price per month is under $350. An analysis of Aetna insurance claims data from CVS revealed that the current pricing of GLP-1 drugs, including Mounjaro, Ozempic, Zepbound, and Wegovy, results in increased spending due to their high cost being unaffordable by lower medical costs.
The study analyzed patients with obesity, diabetes, or other conditions who started using GLP-1 drugs between 2023 and 2025. While the drugs can lead to a 10-12% reduction in emergency room visits during the first and second year of use, plan sponsors experienced a $3,900 increase in prescription costs for every patient over three years, resulting in a net loss of $3,900 per person.
However, the impact of GLP-1s on healthcare costs varies depending on the patient's overall health status; those with higher risks, such as older individuals with diabetes, may see a quicker return on investment.
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