Weight-loss drugs such as Ozempic and Wegovy have become household names. A 2023 survey found that 70% of the U.S. public had heard about glucagon-like peptide-1 drugs, or GLP-1s. A 2024 survey found that 1 in 8 Americans had tried one of these drugs, and nearly half of those surveyed expressed interest in taking one. Many of them could, because almost 40 percent of the country meets the eligibility criteria for GLP-1 usage for weight loss.
The national interest in GLP-1s has prompted action by the executive branch to reduce the cost of the most popular GLP-1s for Medicare and Medicaid recipients. Historically, Medicare’s negotiated prices for pharmaceuticals translate into lower drug costs across the private sector and other payers. Thus, many public and private payers will soon decide whether to provide reimbursement for GLP-1s for weight loss and other conditions besides diabetes, the disease that GLP-1s were originally developed to treat.
Do GLP-1s Work?
The first question healthcare and policy decision-makers may ask is: Do the drugs work? GLP-1s have been approved by the Food and Drug Administration to treat type 2 diabetes, cardiovascular disease, sleep apnea, and obesity, and they could soon be approved to treat heart failure, peripheral artery disease, and osteoarthritis of the knee.
To obtain these approvals, GLP-1s had to be shown in clinical trials to improve the health of people with these conditions. However, clinical trials often do not reflect real-world settings. For example, a clinical trial typically requires participants to consistently use the drug being tested for a defined period, but in real-world settings, people often do not have the same level of adherence. One study found that among participants using semaglutide, a form of GLP-1, only 40% took it consistently for a year.
Another caveat regarding the drugs’ effectiveness is that in the absence of significant lifestyle changes, people who stop using GLP-1s will regain a significant portion of the weight they lost. Thus, some clinicians argue for pairing GLP-1s with nutritional and lifestyle counseling.
Are GLP-1s Cost-Effective?
A second question to consider is whether GLP-1s are cost-effective. A year’s worth of GLP-1s currently costs almost $10,000. The Trump administration has said the price of GLP-1s for Medicare and state Medicaid programs will be set at $245 per month, or just under $3,000 per year. A systematic review and meta-analysis published in 2025 suggested GLP-1s were not cost-effective in treating obesity without diabetes.
A systematic review in 2021 found GLP-1s to be more cost-effective than insulin for treating type 2 diabetes, meaning that GLP-1s achieved the best results in relation to cost. Greater cost-effectiveness does not necessarily mean lower costs, however. A 2025 study found that among people with diabetes who used GLP-1s, medical costs in their first year of treatment with the drugs were more than $700 higher than the medical costs of people with diabetes who did not use GLP-1s.
How Do GLP-1s Compare to Other Weight-Loss Methods?
A third question for consideration is whether the money spent on GLP-1s could be better used for other avenues of weight reduction. Bariatric surgery, the operation of choice to combat severe forms of obesity, typically costs between $20,000 and $30,000. Despite the initial high cost, bariatric surgery, on average, has been shown to result in greater weight loss over time than GLP-1s. Also, GLP-1s require continuous use, resulting in higher costs than bariatric surgery within two years for some forms of the drug, at current pricing.
Investing in non-clinical interventions is another option for reducing obesity and promoting health. The Food Is Medicine movement, for example, aims to improve health through nutrition. A meta-analysis showed that implementing a Food Is Medicine program in which the average cost of a meal is just under $10 resulted in a nearly 20% reduction in participants’ annual healthcare expenditures. Also, investments in public infrastructure to promote physical activity can improve health and reduce weight. A study in Arkansas found that living half a mile from a recreational trail reduced the probability of a child having obesity by two percentage points.
Is Covering GLP-1s Affordable?
Finally, healthcare and policy leaders likely will ask: Can we afford this? In 2024, GLP-1s accounted for about 1% of Medicaid prescriptions but more than 8% of Medicaid pharmaceutical expenditures, before rebates. As of January 2026, 13 states cover GLP-1s for obesity treatment, but this is down from 16 states in October 2025. California was one of the three states to cease broad coverage of GLP-1s due to affordability concerns, with annual costs for that state projected to reach nearly $800 million in four years. Arkansas Medicaid does not currently cover GLP-1s to treat obesity.
Even if payers decide not to cover GLP-1s for obesity, covering the drugs for other conditions can be costly. One study found that nearly 3 in 4 Medicare recipients with obesity also have another condition that GLP-1s are approved to treat. Research currently in progress at ACHI suggests a large portion of Medicaid and private insurance enrollees with obesity in Arkansas similarly have comorbidities that could be treated with GLP-1s.
Given GLP-1s’ popularity and proven clinical significance in treating multiple conditions, they likely have role to play in population health management. It will be up to healthcare and policy decision-makers to determine what that role will be — and how much they are willing to spend on it.
