GLP-1 Medications Continue to Increase Market Growth | Asembia 2025

The pharmaceutical industry is experiencing major transformation, driven by breakthrough glucagon-like peptide-1 (GLP-1) medications, the evolving biosimilar landscape, and complex regulatory changes that are challenging traditional health care delivery models, according to Doug Long, vice president of industry relations at IQVIA, in a session at Asembia’s AXS25 Summit.

Glucagon-like peptide-1 medications are the fastest-growing class of medication and will continue to be prevalent as more indications, such as sleep apnea, are added. | Image Credit: Patrick Bay Damsted - stock.adobe.com

“The total market is $821 billion, and that is at the invoice price basis,” Long said. “The growth rate is accelerating in 2025 from where it was in 2024, and I think some of that has to do with the strong growth of GLP-1s.”

The market growth for specialty medication is approximately 12%, and traditional is approximately 8%, driven by GLP-1 medications.

The market is growing because of the volume, Long said, with a 78% volume growth from 2023 to 2024. However, price did not play a role in growth; it was only volume. Immunology remains the top class of specialty care, with risankizumab (Skyrizi) and dupilumab (Dupixent) driving the growth. However, the top 4 fastest-growing products are GLP-1s, with semaglutide (Mounjaro) at $23.9 billion, semaglutide (Ozempic) at $35.4 billion, tirzepatide (Zepbound) at $7.9 billion, and tirzepatide (Wegovy) at $14.3 billion. Skyrizi and nirmatrelvir and ritonavir (Paxlovid) follow at $16.2 billion and $6.1 billion, respectively.

However, Long stated that GLP-1 medications are not considered specialty, so they do not count towards the market, but 52% of the drug spend is specialty drugs, with only 2% of prescriptions being specialty. Skyrizi, Dupixent, upadacitinib (Rinvoq), and pembrolizumab (Keytruda) are the 4 fastest-growing drugs in the specialty space.

As for community pharmacy, HIV antiviral and immunology are growing at 6.1% and 7.9%, respectively. Lipid regulators and anti-inflammatory and digestive enzymes are among the other top classes for retail.

Although most of the concerns in pharmacy remain the same, such as the Inflation Reduction Act (IRA), biosimilars, drug shortages, staffing challenges, and reimbursement challenges, pharmacists are also concerned about store closures as well as tariffs.

Long stated that he does not know how tariffs will affect everything, but there is a call to manufacture more in the United States. Approximately 75% of COVID-19 drugs, 97% of antibiotics, 83% of the top 100 generic drugs, and 92% of antivirals are sourced from somewhere outside of the United States. In the last 5 years, the US has become dependent on imported pharmaceuticals, with 71% coming from the European Union and over 40% of those coming from Ireland.

The IRA has added semaglutide as a whole molecule to the 2027 drug price negotiation list. This will not only affect Ozempic and Mounjaro but oral semaglutide as well. As far as drug pricing, Canada is expected to launch a generic version of Ozempic within the next 12 months.

“Only 10% of the US population has taken these [GLP-1] drugs... the estimation is that over 50% of the United States is either overweight or obese,” Long said. He stated that there is room for this market to grow even further due to the prevalence of obesity. The obesity market is very crowded, with 157 new assets and 70-plus companies behind these.

Despite the profound effect GLP-1s have on the market, the patient journey remains complicated, and it’s not enough to get the product prescribed anymore. In 2023, approximately 61% of Zepbound and Wegovy claims were rejected, and 16% were abandoned. Over half of new prescriptions for novel medicines go unfilled, and only about 31% of patients remain on therapy for a year, according to Long.

As for drug shortages, they are expected to persist due to demand as well as supply chain issues caused by natural disasters. Furthermore, approximately 70% of drug shortages have been going on for 2 or more years. In the community space, there were over 2700 pharmacies closed in 2023 and 2024 and over 5800 since 2018.

“Currently, there [are about] 16 million people live in a pharmacy desert,” Long said. “That’s important, particularly for the senior citizens, because 1 in 5 senior citizens has 5 prescriptions or more a month, and a lot of the shortages that are either rural or store[s] closed in rural areas or [in] urban areas.”

As stores continue to close, the demand and role of the pharmacist continue to expand, which leads to more burnout. There has also been a shortage of pharmacists as well as pharmacy students.

Further, as of January 2025, the key markets to watch are MASH, respiratory vaccines (particularly respiratory syncytial virus [RSV]), Humira biosimilars, and GLP-1s in the sleep apnea space. Success is supposed to be seen in both RSV vaccines and GLP-1 medications. In 2024, the top therapy areas were oncology, neurology, and cardiovascular.

Read More of Our Coverage: Asembia Specialty Pharmacy Summit

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REFERENCE

Long D. US Pharmaceutical Trends, Issues, and What’s Next?. Presented at: Asembia AXS25 Summit. April 28-May 1, 2025. Las Vegas, Nevada.