List prices for Ozempic, Wegovy far higher in the US than in peer nations: KFF

It's not a secret that Americans pay far more than people living in other countries for drugs, and those data hold for trendy weight loss and diabetes treatments as demand for these therapies grows, according to a new analysis from KFF.

The researchers found that the list price for four top products in this market—Ozempic, Wegovy, Rybelsus and Mounjaro—was highest in the U.S. The U.S. list price for Wegovy, for example, was $1,349, while it was just $328 in the Netherlands and $296 in Sweden.

A one-month supply of Ozempic has a list price of $936 in the U.S., according to the report, while it cost just $83 in France and $87 in Australia.

"Increased off-label use of these drugs is contributing to supply shortages for people who use these drugs for diabetes and employer health plans and insurers are scrutinizing the prescribing of the drugs," the analysts wrote in the report. "How these drugs are priced will influence how accessible they are to patients, how insurers cover them, and ultimately overall health spending."

Rybelsus, an oral version of semaglutide, the same drug in Ozempic and Wegovy, carries a list price of $936. That falls as low as $69 for a monthly supply in Japan, according to the report. Mounjaro, an injectable tirzepatide therapy, has a $1,023 list price in the U.S. compared to a $444 price in the Netherlands and $319 in Canada.

Ozempic is the most widely available drug included in the analysis, and prices in all countries listed were far lower. 

That said, list price is not necessarily the final word in how much is actually paid for a drug, the researchers said. Manufacturers generally offer discount coupons on branded products; Novo Nordisk, for example, offers coupons for both insured and uninsured patients. Insurers and pharmacy benefit managers can also negotiate lower prices or can secure higher rebates to bring down the cost to the plan and the patient.

Another factor to consider beyond pricing, according to report, is how many people will be using these therapies. While interest in them for off-label prescribing is grabbing headlines, the U.S. also has the highest rates of obesity in the world, meaning potential use would be elevated even if the drugs weren't currently trendy.

The U.S. has a 33.5% prevalence of obesity, the researchers said. By comparison, the next-highest country was the U.K. at 25.9%.

KFF found in prior polling that half of U.S. adults would be interested in prescription weight loss drugs, though interest does wane if the products were not covered by insurance. The jury is also still out on certain side effects and on whether patients must continue taking the drugs in a long-term regimen, which would also balloon costs given the already high prices.

"Higher prices of drugs for weight loss and higher rates of obesity in the U.S. could mean a more significant impact of these drugs on overall health spending in the U.S. than in peer countries," the researchers wrote.