Many insured U.S. patients pay less than $25 a month

Novo Nordisk on Thursday said 80% of U.S. patients with insurance coverage who take its highly popular weight loss treatment Wegovy are paying less than $25 a month for the drug. 

The remarks suggest that many insured Americans don’t have to shoulder the full cost of a monthly package of Wegovy, which has a list price of around $1,350. It also comes as many U.S. health insurers balk at the extreme cost of Wegovy and other obesity drugs while dropping them from their plans, even as demand for those treatments soar nationwide and outpace supply. 

But Doug Langa, Novo Nordisk’s vice president for North America, said on a third-quarter earnings call Thursday that most major health plans and pharmacy benefit managers are covering Wegovy. 

Langa acknowledged that some employers are opting out of coverage, but noted that the company overall is seeing more insurers opt in to cover the weekly injection.

He estimated that about 50 million Americans with obesity could be eligible for Wegovy coverage under their health plans.

“Directionally, we’re heading in the right direction and our focus will be continuing on securing employer coverage as well as stronger access for Americans overall,” Langa said during the call. 

However, the $25 out-of-pocket cost will likely add up over time. Most patients have to take Wegovy for several months to see – and sustain – significant weight loss. 

Wegovy, for example, leads to 15% weight loss after 68 weeks, according to clinical trials on the drug.

The longer treatment duration is also one reason why some health insurers are hesitant to cover Wegovy and similar weight loss drugs, which typically work by mimicking a hormone produced in the gut to suppress a person’s appetite.

At roughly $1,000 per month on average for medications that are typically taken for months or even a year, the drugs are straining insurers’ budgets.

But Novo Nordisk is hoping that new data demonstrating the heart health benefits of Wegovy will put more pressure on insurers to cover the medication and similar weight loss treatments. 

A recent late-stage trial found that Wegovy reduced the risk of cardiovascular events like heart attack and stroke by 20%. The results suggest that Wegovy and similar obesity and diabetes medications like those in development by Eli Lilly and others could have long-lasting health benefits beyond shedding unwanted pounds.

Novo Nordisk CFO Karsten Munk Knudsen told CNBC on Thursday that Wegovy could receive expanded approval from the U.S. Food and Drug Administration as a treatment for reducing the risk of cardiovascular disease within six months.

More than two in five adults have obesity, according to the National Institutes of Health.

About one in 11 adults have severe obesity.