Weight-Loss Drugs Fuel Rise in US Prescription Spending


The rise of weight-loss drugs has overtaken the US prescription drug market and significantly increased spending from 2022 to 2023.

In 2023, prescription drug spending grew 13.6% compared with 2022 and semaglutide was the highest selling drug due to a recent increase of weight-loss classifications.

“Expenditures for semaglutide doubled last year, making it the new top-selling drug in the US, replacing adalimumab, which treats autoimmune diseases like rheumatoid arthritis and Crohn's disease,” wrote the American Society of Health-System Pharmacists in a press release.1 “Adding to the weight-loss category, spending on the diabetes drug tirzepatide grew an astounding 373% even though its approval for weight loss came late in 2023.”

Key Takeaways

  • From 2022 to 2023, US prescription drug spending increased by over 13.5%.
  • Semaglutide overtook adalimumab as the most-purchased drug in the country as more attention continues to follow weight-loss medications in the US.
  • Despite Americans' mixed opinions on newly approved drugs for weight-loss, researchers predict an even further increase of spending for these drugs in 2024.

Drugs like semaglutide and tirzepatide were originally classified as diabetes medications but have since been approved for weight-loss indications. According to researchers, the evolution of weight-loss medications is following a continuous trend of increased spending beyond 2023.

In 2024, they predict US prescription drug spending to increase another 10% to 12%. And while weight-loss drugs led the charge by the end of 2023, demand for endocrine and cancer drugs continues to fuel spending.2

READ MORE: Focus On Obesity Management Before Addressing Comorbidities

weight-loss medication tablets and injections

In 2023, Novo Nordisk saw combined sales of $21.1 billion from its drugs Wegovy, Ozempic, and Rybelsus. | image credit: K KStock / stock.adobe.com

The Rise of Weight-Loss Drug Spending in the US

Whether patients are using these drugs for weight-loss or diabetes management, in 2023, Novo Nordisk saw combined sales of $21.1 billion from its drugs Wegovy, Ozempic, and Rybelsus. This accounts for an 89% revenue increase for the Danish drug manufacturer from these 3 drugs alone, according to a Pew Research study.3

Furthermore, 71% of worldwide semaglutide sales came from the US, a country where almost 75% of adults over 20 are considered obese (42%) or overweight (31%).3

“For now, the public has modest expectations for the impact drugs like Ozempic and Wegovy will have on obesity in the United States. Only 16% of those familiar with these drugs think they will do a great deal or quite a bit to reduce obesity, while 35% think they will do some and 33% expect they will do not much or nothing at all to reduce obesity in the US,” wrote Tyson and Kikuchi regarding another Pew Research study.4

Between the mixed-use of drugs like semaglutide and tirzepatide for either weight-loss or diabetes, and the country’s modest sentiment supporting their use for weight-loss, what exactly Americans are using these drugs to treat is a bit uncertain.

“Just 12% of those familiar with these drugs say they are good options for people who want to lose weight but do not have a weight-related health condition. A far larger share (62%) say these drugs are not good options for people without a weight-related health condition, while 26% aren’t sure,” continued Tyson and Kikuchi.4

These statistics show that the recent rise of semaglutide sales could be further enforced by increased marketing and public attention. Beverly Tchang, MD, endocrinologist, and assistant professor of clinical medicine at Weill Cornell Medicine and New York Presbyterian Hospital, recently expressed her concerns about weight-loss drugs in an Everyday Health article addressing a semaglutide shortage.

“I worry more that people who do not have obesity or diabetes are buying semaglutide at its out-of-pocket cost to get skinnier, likely stirred on by TikTok videos or Variety articles. Patients with diabetes and patients with obesity both deserve treatment, and the shortage of semaglutide in general affects both populations,” she said.5

But regardless of their preferred uses, the rise in semaglutide and tirzepatide sales have manufacturers ready to roll out a larger inventory of their weight-loss drugs and researchers are certain of their continued increase.2

“Several new drugs that will influence spending are expected to be approved in 2024,” wrote the authors.2 Because of their uses among diabetics, overweight individuals, and healthy individuals trying to lose weight, it is not naïve to predict that weight-loss medications will occupy future lists of newly accepted medications.

READ MORE: Wegovy Represents New Weight Loss Drug Story

1. Enormous demand for weight-loss drugs drives up total U.S. prescription spending. PR Newswire. April 24, 2024. Accessed May 2, 2024. https://www.prnewswire.com/news-releases/enormous-demand-for-weight-loss-drugs-drives-up-total-us-prescription-spending-302125178.html
2. Tichy EM, Hoffman JM, Tadrous M, et al. National trends in prescription drug expenditures and projections for 2024. Am J Health Syst Pharm. Published online April 24, 2024. doi:10.1093/ajhp/zxae105
3. DeSilver D. As obesity rates rise in the U.S. and worldwide, new weight-loss drugs surge in popularity. Pew Research Center. March 21, 2024. Accessed May 2, 2024. https://www.pewresearch.org/short-reads/2024/03/21/as-obesity-rates-rise-in-the-us-and-worldwide-new-weight-loss-drugs-surge-in-popularity/
4. Tyson A, Kikuchi E. How Americans view weight-loss drugs and their potential impact on obesity in the U.S. Pew Research Center. February 26, 2024. Accessed May 2, 2024. https://www.pewresearch.org/science/2024/02/26/how-americans-view-weight-loss-drugs-and-their-potential-impact-on-obesity-in-the-u-s/
5. Rapaport L. Ozempic shortage: what people with diabetes need to know. Everyday Health. December 4, 2023. Accessed May 2, 2024. https://www.everydayhealth.com/type-2-diabetes/ozempic-shortage-how-a-weight-loss-fad-has-slashed-access/
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