In recent years, the rising costs of prescription drugs have become a major concern for patients and healthcare providers alike. What can people expect to pay for drugs like Ozempic and Wegovy in the treatment of type 2 diabetes and obesity? It’s a good question! And to answer it, we must factor for costs as a whole, including drug pricing, treatment duration, insurance coverage, and potential cost-saving strategies. Here’s a long-term look at the effects and costs of Ozempic and Wegovy.
Drug Pricing
Ozempic and Wegovy are both innovative medications that have demonstrated efficacy in their respective therapeutic areas. Ozempic (generic name semaglutide) is a once-weekly injectable drug used for glycemic control in patients with type 2 diabetes, while Wegovy (generic name semaglutide, and yes, this is the same drug) is a once-weekly injectable drug used for weight management in individuals with obesity
According to one published September 2021 report, Ozempic’s average wholesale price (AWP) in the United States was approximately $850 for a monthly supply. Wegovy, being a newer medication, did not have an established AWP at that time. However, it is essential to note that drug prices can vary over time due to several factors, including market competition, negotiated discounts, and policy changes. Therefore, it is recommended to consult the most recent drug price data or contact a healthcare professional or pharmacist to obtain accurate pricing information.
A quick cost check for these medications in Reno, Nevada, on GoodRx from my computer shows the cheapest monthly cost for Wegovy is $1,391.00. The cheapest for is $905.54 for Ozempic. Maunjaro, a similar drug, is $1,057.00 and may sometimes have a coupon card.
Treatment Duration
To estimate the long-term costs, we need to consider the duration for which these medications would be used. The length of treatment will depend on individual patient needs, response to therapy, and healthcare provider recommendations. It is essential to follow the prescribed treatment plan and consult with a healthcare professional regarding the appropriate duration of therapy.
For the purpose of estimation, let’s assume a treatment duration of five years, which is a commonly used timeframe in clinical trials and long-term studies. Based on our prices above, here’s what that costs:
- Wegovy: $16,692 for a year of treatment; $83,460 for five years
- Ozempic: $10,867 for a year of treatment; $54,333 for five years
- Maunjaro: $12,685 for a year of treatment; $63,420 for five years
Of course, bear in mind that like a blood pressure medication or another drug to lower blood sugar, when you stop the drug you should expect the body weight to climb back up again. In other words, these are long-term medications.
Insurance Coverage
Those are eye popping costs, to be sure, so what about insurance? Indeed, the availability and extent of insurance coverage play a crucial role in determining out-of-pocket costs for patients. Insurance plans can vary widely in terms of formulary coverage, co-payments, and deductibles. At present we find almost no plans cover the cost of Ozempic and Wegovy for obesity treatment, thus requiring patients to pay a portion or the full cost.
To determine the actual cost for an individual, it is vital of course to review the specific insurance plan details, including coverage levels, tier placement, and any potential restrictions or prior authorization requirements.
Cost-Saving Strategies
Several strategies can be employed to mitigate the financial burden of long-term medication use. These include:
- Patient assistance programs: Pharmaceutical companies often offer patient assistance programs that provide financial support or discounted medications to eligible individuals who meet specific criteria. These programs can help reduce the out-of-pocket costs for patients.
- Manufacturer coupons or savings cards: Some drug manufacturers provide coupons or savings cards that can be used to reduce the cost of medications. These savings programs can be accessed through the manufacturer’s website or obtained from healthcare providers.
- Generic alternatives: Over the next five to seven years, generic versions of medications will hopefully become available, offering potential cost savings compared to brand-name drugs. However, it is important to note that the availability of generic versions for Ozempic and Wegovy may vary depending on patent exclusivity and regulatory approvals.
The Bottom Line
Estimating the exact cost of using Ozempic or Wegovy for several years can be challenging due to the dynamic nature of drug pricing and insurance coverage. Still, it’s certainly possible to estimate potential financial implications, and there’s no question that they’re considerable: using a ballpark round number of $1,000.00 per month, a person’s out of pocket cost for the medication over five years will be $60,000.00.
To obtain accurate cost estimates, it is advisable to consult with healthcare professionals, insurance providers, or pharmacists who can provide personalized information based on current drug prices, insurance coverage, and individual circumstances. By proactively exploring available cost-saving options, patients can navigate the complexities of drug costs and make informed decisions regarding their treatment journey.
