KFF: Part D spending on Ozempic skyrocketed between 2018 and 2022

Spending on GLP-1 drugs in Medicare Part D has spiked massively over the past several years, according to a new analysis from KFF.

Researchers at the organization dug into newly released data from the Centers for Medicare & Medicaid Services on spending in Part D and found that the program spent just $56.8 million in 2018 on Novo Nordisk's Ozempic, which secured Food and Drug Administration approval in treating diabetes in 2017.

By 2019, spending on Ozempic in Part D grew to $552.8 million, according to the analysis. That number continued to steadily rise, reaching $2.6 billion in 2021 and then an eye-popping $4.6 billion by 2022, KFF found.

The researchers also incorporated data on other drugs in this class, Novo's Rybelsus and Eli Lilly's Mounjaro. Part D plans spent $73.4 million on Rybelsus in 2019, and that grew to $974.9 million by 2022. 

$144 million was spent in Part D on Mounjaro in 2022, according to the report. All told, Part D spending on these three GLP-1s alone reached $5.7 billion in 2022.

"These drugs offer substantial potential health benefits, but the combination of intense demand, new uses, and high prices for these treatments is likely to place tremendous pressure on Medicare spending, Part D plan costs and premiums for Part D coverage," the researchers wrote.

The study noted that Ozempic rose from being 10th on the list of drugs with the highest total gross spending in 2021 to sixth in 2022, jumping high-profile drugs like Humira on the list. Gross spending does not account for rebates on these products, KFF said.

The analysts said that given the high demand and high cost of these products, semaglutide could be selected for negotiation in Medicare as early as 2025, meaning a negotiated price would be available in 2027. The negotiation process could drive a far lower price, according to the report.

They also called out that Part D plans are set to begin covering these drugs for other indications, beginning with coverage for Wegovy for patients in certain weight categories to prevent cardiovascular disease. Broader coverage naturally begets greater spending.

"The fact that covering GLP-1s under Medicare Part D for authorized uses is already making a mark on total Part D program spending could be a sign of even higher spending to come as Part D plans are now able to cover Wegovy for its heart health benefits, as other uses for GLP-1s are approved, and as policymakers consider legislation that would authorize Medicare to cover obesity drugs," the researchers said.