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GLP-1 / EVIDENCE MONITOR

GLP-1 Cost & Insurance Coverage

Look at the research on affordability, coverage and the economics of treatment.

7 cited sources24 recorded findingsStudy findings updated

AI-assisted research summary. These summaries are for general information. Read the original source for the full study and its limitations.

THE SHORT VERSION

What’s worth knowing.

The key findings, what they mean, and the context that matters.

THE HEADLINE TAKEAWAY

Private access was 47.8% for Australian GLP-1 medicines indicated for type 2 diabetes

During May 2024-April 2025, 47.8% of access was private overall, including 26.9% of semaglutide access and all tirzepatide access.

Australian use of GLP-1 medicines indicated for type 2 diabetes. Actual patient payments and the treatment indication for each use are not available in this summary.

See the evidence

Private access to GLP-1 medicines indicated for type 2 diabetes in Australia during May 2024-April 2025

47.8% privately accessed overall; 26.9% of semaglutide and all tirzepatide

Falster, Michael O et al.. Trends in publicly subsidized and private access to GLP-1 medicines indicated for type 2 diabetes in Australia, 2020-2025.. British journal of clinical pharmacology. 2026.

Added

02

Expanded indications and Medicare coverage coincided with more Wegovy fills

The policy changes were associated with additional Wegovy fills by September 2024; Medicare Part D utilization increased.

This is a policy-period association, not evidence that policy alone caused the increase. The comparison used to estimate additional fills is not available in this summary. Patient counts, payments and reasons for individual fills are not available in this summary.

See the evidence

Estimated additional Wegovy fills associated with expanded FDA indications and Medicare coverage by September 2024

592,624 additional fills

Scannell, Christopher et al.. Changes in Semaglutide Fills Following Expanded FDA and Medicare Policies.. The American journal of managed care. 2026.

Added

Relative increase in Wegovy utilization through Medicare Part D

598.1% increase

Scannell, Christopher et al.. Changes in Semaglutide Fills Following Expanded FDA and Medicare Policies.. The American journal of managed care. 2026.

Added

03

GLP-1 medicines accounted for 42.7% of Croatia's noninsulin antidiabetic spending

In Croatia in 2024, expenditure was €42.07 million, or 42.7% of total noninsulin antidiabetic spending; utilization was 16.1% of total prescriptions.

These are national utilization and expenditure totals. The split between insurer and patient spending, and individual affordability, are not available in this summary.

See the evidence

National expenditure on GLP-1 RAs in Croatia in 2024

€42.07 million; 42.7% of total noninsulin antidiabetic spending

Belančić, Andrej et al.. Trends in glucagon-like peptide-1 receptor agonist utilization and expenditure in Croatia.. The Journal of international medical research. 2026.

Added

National GLP-1 RA utilization in Croatia in 2024

15.99 defined daily doses per 1000 inhabitants per day; 16.1% of total prescriptions

Belančić, Andrej et al.. Trends in glucagon-like peptide-1 receptor agonist utilization and expenditure in Croatia.. The Journal of international medical research. 2026.

Added

04

Lower healthcare costs excluding tirzepatide did not establish net savings

-$319 per person per month (25.4% reduction)

At 12-18 months, changes in all-cause healthcare costs differed by -$319 per person per month for tirzepatide users versus matched untreated controls. Tirzepatide costs were excluded; inpatient or emergency visits were also less frequent.

Older adults with obesity or overweight without diabetes. This was a propensity score-matched cohort analysis; because tirzepatide was excluded, total net savings were not measured.

See the evidence

Difference-in-differences estimate for all-cause healthcare costs excluding tirzepatide at 12-18 months versus propensity score-matched untreated controls

-$319 per person per month (25.4% reduction)
95% CI: -$544 to -$94

Upadhyay, Navneet et al.. Trends in Cost of Care With Tirzepatide in Adults Aged Over 55 Years With Obesity or Overweight Without Diabetes: A Matched Cohort Analysis.. Diabetes, obesity & metabolism. 2026.

Added

Inpatient/emergency department visit incidence with tirzepatide versus untreated controls during 12-18 months

IRR 0.69
95% CI: 0.50-0.94

Upadhyay, Navneet et al.. Trends in Cost of Care With Tirzepatide in Adults Aged Over 55 Years With Obesity or Overweight Without Diabetes: A Matched Cohort Analysis.. Diabetes, obesity & metabolism. 2026.

Added

05

Peru's semaglutide estimate used a high-cost retail scenario

The semaglutide 2.4 mg estimate was S/16,804.86 per patient in year 1 and S/18,135.52 per patient in a maintenance year.

A supplementary high-cost non-governmental retail scenario, not an expected institutional procurement estimate. Observed patient payments are not available in this summary.

See the evidence

Semaglutide 2.4 mg costs in a supplementary high-cost non-governmental retail scenario, not an expected institutional procurement estimate.

S/16,804.86 per patient in year 1; S/18,135.52 per patient in a maintenance year

Vera Ponce, Victor J. Projected budget impact of pharmacotherapy scenarios for obesity and related conditions in Peru: A national survey analysis of 76,819 participants.. Obesity pillars. 2026.

Added

06

Cost-effectiveness results changed by treatment and obesity class

For class I-II obesity, endoscopic sleeve gastroplasty was cost-effective versus semaglutide; the analysis favored semaglutide over intragastric balloon therapy.

Laparoscopic sleeve gastrectomy was also cost-effective versus endoscopic sleeve gastroplasty for class II-III obesity. The design and assumptions are not available in this summary.

See the evidence

Cost-effectiveness of endoscopic sleeve gastroplasty versus semaglutide for class I-II obesity

£7,267/QALY

Afentou, Nafsika et al.. Cost-Effectiveness of Endoscopic Bariatric Therapies Compared with Laparoscopic Sleeve Gastrectomy and Semaglutide.. Obesity surgery. 2026.

Added

Semaglutide versus intragastric balloon therapy

Semaglutide dominant

Afentou, Nafsika et al.. Cost-Effectiveness of Endoscopic Bariatric Therapies Compared with Laparoscopic Sleeve Gastrectomy and Semaglutide.. Obesity surgery. 2026.

Added

Cost-effectiveness of laparoscopic sleeve gastrectomy versus endoscopic sleeve gastroplasty for class II-III obesity

£10,593/QALY

Afentou, Nafsika et al.. Cost-Effectiveness of Endoscopic Bariatric Therapies Compared with Laparoscopic Sleeve Gastrectomy and Semaglutide.. Obesity surgery. 2026.

Added

Study-specific findings. Different populations, treatments and follow-up periods can produce different results.

THE RESEARCH, AS IT ARRIVES

Latest studies.

The newest findings added to this collection.
The learning from each, already distilled.

  1. STUDY 01Findings added
    TL;DR

    Matched tirzepatide users had lower healthcare costs excluding tirzepatide

    -$319 per person per month (25.4% reduction)

    Healthcare cost changes for tirzepatide users differed from matched untreated controls by -$145 per person per month at 6-12 months and -$319 at 12-18 months, with tirzepatide excluded; inpatient or emergency visit incidence was also lower later.

    Older adults with obesity or overweight without diabetes. This was a propensity score-matched cohort analysis, and tirzepatide costs were excluded.

    Study details & original results

    Upadhyay, Navneet et al.. Trends in Cost of Care With Tirzepatide in Adults Aged Over 55 Years With Obesity or Overweight Without Diabetes: A Matched Cohort Analysis.. Diabetes, obesity & metabolism. 2026.

    Difference-in-differences estimate for all-cause healthcare costs excluding tirzepatide at 6-12 months versus propensity score-matched untreated controls

    -$145 per person per month (12.3% reduction)
    95% CI: -$266 to -$25

    Difference-in-differences estimate for all-cause healthcare costs excluding tirzepatide at 12-18 months versus propensity score-matched untreated controls

    -$319 per person per month (25.4% reduction)
    95% CI: -$544 to -$94

    Inpatient/emergency department visit incidence with tirzepatide versus untreated controls during 12-18 months

    IRR 0.69
    95% CI: 0.50-0.94

    Citation in Cost & coverage
  2. STUDY 02Findings added
    TL;DR

    Policy expansion was associated with a large rise in Wegovy fills

    By September 2024, expanded indications and Medicare coverage were associated with additional Wegovy fills. Overall utilization rose 136.4% compared with the prepolicy period; Medicare Part D utilization also increased.

    A policy-period utilization association. The comparison used to estimate additional fills is not available in this summary. Fill counts are not patient counts, and patient payments and health outcomes are not available in this summary.

    Study details & original results

    Scannell, Christopher et al.. Changes in Semaglutide Fills Following Expanded FDA and Medicare Policies.. The American journal of managed care. 2026.

    Estimated additional Wegovy fills associated with expanded FDA indications and Medicare coverage by September 2024

    592,624 additional fills

    Relative increase in Wegovy utilization compared with the prepolicy period

    136.4% increase

    Relative increase in Wegovy utilization through Medicare Part D

    598.1% increase

    Citation in Cost & coverage
  3. STUDY 03Findings added
    TL;DR

    GLP-1 medicines accounted for 42.7% of Croatia's noninsulin antidiabetic spending

    In Croatia in 2024, expenditure was €42.07 million and 42.7% of total noninsulin antidiabetic spending; utilization was 16.1% of prescriptions.

    National utilization and expenditure totals. The division between insurer and patient spending, and affordability for individual users, are not available in this summary.

    Study details & original results

    Belančić, Andrej et al.. Trends in glucagon-like peptide-1 receptor agonist utilization and expenditure in Croatia.. The Journal of international medical research. 2026.

    National expenditure on GLP-1 RAs in Croatia in 2024

    €42.07 million; 42.7% of total noninsulin antidiabetic spending

    National GLP-1 RA utilization in Croatia in 2024

    15.99 defined daily doses per 1000 inhabitants per day; 16.1% of total prescriptions

    Citation in Cost & coverage
  4. STUDY 04Findings added
    TL;DR

    Peru's liraglutide and semaglutide estimates used high-cost retail scenarios

    At hypothetical 100% coverage, the projected annual gross medication-acquisition budget for liraglutide under the broad criterion was S/142.95 billion. A separate semaglutide 2.4 mg scenario was S/16,804.86 per patient in year 1.

    The projection used 76,819 pooled survey records. Both used high-cost non-governmental retail scenarios, not expected institutional procurement estimates; they concern different medicines and scales.

    Study details & original results

    Vera Ponce, Victor J. Projected budget impact of pharmacotherapy scenarios for obesity and related conditions in Peru: A national survey analysis of 76,819 participants.. Obesity pillars. 2026.

    Projected annual gross medication-acquisition budgets at hypothetical 100% coverage. Naltrexone/bupropion used an IETSI-reported scenario; liraglutide was a high-cost non-governmental retail scenario rather than an expected institutional procurement estimate, and phentermine/topiramate was an exploratory supplementary comparator.

    Broad criterion: S/142.95 billion for liraglutide, S/23.65 billion for naltrexone/bupropion, and S/26.83 billion for phentermine/topiramate; pragmatic priority: S/57.95 billion, S/9.59 billion, and S/10.88 billion, respectively

    Semaglutide 2.4 mg costs in a supplementary high-cost non-governmental retail scenario, not an expected institutional procurement estimate.

    S/16,804.86 per patient in year 1; S/18,135.52 per patient in a maintenance year

    Survey-observable candidate populations in Peru estimated from pooled ENDES 2022-2024 data comprising 76,819 records.

    7.54 million adults with BMI-defined obesity; 9.04 million meeting the broad criterion; 3.67 million meeting pragmatic priority

    Citation in Cost & coverage
4 of 7 study updates

Dates show when findings were added here, not when papers were published. Study populations and comparisons differ.

WHEN YOU WANT TO GO DEEPER
See all 24 findingsOriginal results, comparisons and study details.
7 of 7 source groupsFindings stay together with their study.
SOURCE 063 findings

Upadhyay, Navneet et al.. Trends in Cost of Care With Tirzepatide in Adults Aged Over 55 Years With Obesity or Overweight Without Diabetes: A Matched Cohort Analysis.. Diabetes, obesity & metabolism. 2026.

Difference-in-differences estimate for all-cause healthcare costs excluding tirzepatide at 6-12 months versus propensity score-matched untreated controls

Added
-$145 per person per month (12.3% reduction)95% CI: -$266 to -$25Source [6]

Difference-in-differences estimate for all-cause healthcare costs excluding tirzepatide at 12-18 months versus propensity score-matched untreated controls

Added
-$319 per person per month (25.4% reduction)95% CI: -$544 to -$94Source [6]
All 3 findings from this source

Inpatient/emergency department visit incidence with tirzepatide versus untreated controls during 12-18 months

Added
IRR 0.6995% CI: 0.50-0.94Source [6]
SOURCE 073 findings

Scannell, Christopher et al.. Changes in Semaglutide Fills Following Expanded FDA and Medicare Policies.. The American journal of managed care. 2026.

Relative increase in Wegovy utilization compared with the prepolicy period

Added
136.4% increaseSource [7]

Relative increase in Wegovy utilization through Medicare Part D

Added
598.1% increaseSource [7]
All 3 findings from this source

Estimated additional Wegovy fills associated with expanded FDA indications and Medicare coverage by September 2024

Added
592,624 additional fillsSource [7]
SOURCE 052 findings

Belančić, Andrej et al.. Trends in glucagon-like peptide-1 receptor agonist utilization and expenditure in Croatia.. The Journal of international medical research. 2026.

National GLP-1 RA utilization in Croatia in 2024

Added
15.99 defined daily doses per 1000 inhabitants per day; 16.1% of total prescriptionsSource [5]

National expenditure on GLP-1 RAs in Croatia in 2024

Added
€42.07 million; 42.7% of total noninsulin antidiabetic spendingSource [5]
SOURCE 043 findings

Vera Ponce, Victor J. Projected budget impact of pharmacotherapy scenarios for obesity and related conditions in Peru: A national survey analysis of 76,819 participants.. Obesity pillars. 2026.

Survey-observable candidate populations in Peru estimated from pooled ENDES 2022-2024 data comprising 76,819 records.

Added
7.54 million adults with BMI-defined obesity; 9.04 million meeting the broad criterion; 3.67 million meeting pragmatic prioritySource [4]

Projected annual gross medication-acquisition budgets at hypothetical 100% coverage. Naltrexone/bupropion used an IETSI-reported scenario; liraglutide was a high-cost non-governmental retail scenario rather than an expected institutional procurement estimate, and phentermine/topiramate was an exploratory supplementary comparator.

Added
Broad criterion: S/142.95 billion for liraglutide, S/23.65 billion for naltrexone/bupropion, and S/26.83 billion for phentermine/topiramate; pragmatic priority: S/57.95 billion, S/9.59 billion, and S/10.88 billion, respectivelySource [4]
All 3 findings from this source

Semaglutide 2.4 mg costs in a supplementary high-cost non-governmental retail scenario, not an expected institutional procurement estimate.

Added
S/16,804.86 per patient in year 1; S/18,135.52 per patient in a maintenance yearSource [4]
SOURCE 034 findings

Falster, Michael O et al.. Trends in publicly subsidized and private access to GLP-1 medicines indicated for type 2 diabetes in Australia, 2020-2025.. British journal of clinical pharmacology. 2026.

Change in total Australian sales of GLP-1 medicines indicated for type 2 diabetes from May 2020 through April 2025

Added
Almost 10-fold increaseSource [3]

Private access to GLP-1 medicines indicated for type 2 diabetes in Australia during May 2024-April 2025

Added
47.8% privately accessed overall; 26.9% of semaglutide and all tirzepatideSource [3]
All 4 findings from this source

Distribution of Australian GLP-1 medicine use by product during May 2024-April 2025

Added
Semaglutide 63.3%; tirzepatide 30.7%Source [3]

Estimated monthly Australian access to GLP-1 medicines indicated for type 2 diabetes during May 2024-April 2025

Added
483,000-502,000 monthly users; 180,000-240,000 accessing privatelySource [3]
SOURCE 023 findings

Afentou, Nafsika et al.. Cost-Effectiveness of Endoscopic Bariatric Therapies Compared with Laparoscopic Sleeve Gastrectomy and Semaglutide.. Obesity surgery. 2026.

Cost-effectiveness of laparoscopic sleeve gastrectomy versus endoscopic sleeve gastroplasty for class II-III obesity

Added
£10,593/QALYSource [2]

Cost-effectiveness of endoscopic sleeve gastroplasty versus semaglutide for class I-II obesity

Added
£7,267/QALYSource [2]
All 3 findings from this source

Semaglutide versus intragastric balloon therapy

Added
Semaglutide dominantSource [2]
SOURCE 016 findings

Kozato, Akio et al.. Evolving utilization of bariatric surgery since the rise of semaglutide and tirzepatide.. Surgical endoscopy. 2026.

Bariatric surgery utilization decline from Q4 2022 peak through Q4 2025

Added
39% decreaseSource [1]

Proportion of bariatric surgery patients with pre-surgery GLP-1RA use in Q4 2025

Added
All 6 findings from this source

Baseline proportion of bariatric surgery patients with pre-surgery GLP-1RA use in Q4 2018

Added

Type 2 diabetes as factor associated with receiving pre-surgery GLP-1RA

Added
RR 2.942.88-3.00Source [1]

15-fold variation in pre-surgery GLP-1RA use between highest and lowest hospitals

Added
RR 0.19-2.88Source [1]

Increase in proportion of Hispanic bariatric surgery patients from Q4 2018 to Q4 2025

Added
8.1% vs. 16.8%Source [1]
Browse the 7 original sourcesThe full bibliography behind this monitor.
  1. [1]

    Kozato, Akio et al.. Evolving utilization of bariatric surgery since the rise of semaglutide and tirzepatide.. Surgical endoscopy. 2026.

    Open original source in a new tab
  2. [2]

    Afentou, Nafsika et al.. Cost-Effectiveness of Endoscopic Bariatric Therapies Compared with Laparoscopic Sleeve Gastrectomy and Semaglutide.. Obesity surgery. 2026.

    Open original source in a new tab
  3. [3]

    Falster, Michael O et al.. Trends in publicly subsidized and private access to GLP-1 medicines indicated for type 2 diabetes in Australia, 2020-2025.. British journal of clinical pharmacology. 2026.

    Open original source in a new tab
  4. [4]

    Vera Ponce, Victor J. Projected budget impact of pharmacotherapy scenarios for obesity and related conditions in Peru: A national survey analysis of 76,819 participants.. Obesity pillars. 2026.

    Open original source in a new tab
  5. [5]

    Belančić, Andrej et al.. Trends in glucagon-like peptide-1 receptor agonist utilization and expenditure in Croatia.. The Journal of international medical research. 2026.

    Open original source in a new tab
  6. [6]

    Upadhyay, Navneet et al.. Trends in Cost of Care With Tirzepatide in Adults Aged Over 55 Years With Obesity or Overweight Without Diabetes: A Matched Cohort Analysis.. Diabetes, obesity & metabolism. 2026.

    Open original source in a new tab
  7. [7]

    Scannell, Christopher et al.. Changes in Semaglutide Fills Following Expanded FDA and Medicare Policies.. The American journal of managed care. 2026.

    Open original source in a new tab
ABOUT THIS MONITOR

The evidence, with its limits.

Study findings are generated with AI assistance and have not been reviewed by a clinician. The date on each finding records when it was added to this monitor; it is not the publication date or a clinical review date.

This monitor does not offer individual treatment advice. Bring personal health questions to a qualified clinician.