Two-Year GLP-1 Therapy for Obesity Linked to Significant Cost Increase Without Medical Spend Offset
A recent real-world analysis presented at AMCP 2025 found that persistent use of glucagon-like peptide-1 (GLP-1) therapy for obesity among adults without diabetes led to a significant increase in total cost of care (TCC) over 2 years, with no observed reductions in medical spending.
Using pharmacy and medical claims data from Prime Therapeutics, researchers identified 3046 commercially insured members who initiated GLP-1 therapy between January 1 and December 31, 2021. After applying persistence criteria—defined as no therapy gap of 60 or more days over 730 days—and matching with GLP-1–naïve controls (3:1), the final cohort included 436 persistent GLP-1 users and 1249 matched controls.
TCC was calculated annually over 1 year before treatment and the 2 years following initiation. For GLP-1 users, average TCC rose from $14 418 in the pre-treatment year to $28 309 in year 1 and $27 909 in year 2. In comparison, controls averaged $13 457, $12 314, and $13 863, respectively.
The difference-in-difference (DID) analysis showed that TCC for GLP-1 users was $15 034 higher in year 1 (P < .0001) and $13,085 higher in year 2 (P < .0001) compared to controls. Notably, there were no statistically significant differences in medical spending between groups, indicating that the cost increase was primarily driven by pharmacy claims.
“This real-world GLP-1 study found a significant $26 118 average per-member TCC investment in the first 2 years following GLP-1 obesity treatment initiation for members without DM who were persistent to therapy,” the authors stated.
Despite the increased costs, medical claims trends remained stable between the GLP-1 and control groups. “No differences in annual medical spend trends were observed between groups,” the study reported. These findings suggest that payers and employers should anticipate substantial short-term financial investment when covering GLP-1 therapies for obesity in populations without diabetes. Long-term clinical or economic benefits, including potential medical cost avoidance, remain uncertain.
Reference
Urick B, Qiu Y, Friedlander N, Leslie S, Gleason P, Marshall L. Two-year persistent glucagon-like peptide-1 agonist obesity without diabetes treatment: cost-effectiveness among commercially insured. Presented at: AMCP 2025; March 31-April 3; Houston, TX.
