John Cawley

Professor, Cornell Brooks School of Public Policy

John Cawley, professor of economics and public policy, researches the economics of diet, physical activity and obesity.

Cawley says:

“Americans do pay the highest prices for prescription drugs in the world, and this is also true for the new GLP-1 weight loss drugs. Patients in even similar high-income countries like Canada and Denmark face prices that are far less than the list price in the U.S.

“Although the list prices of GLP-1s in the U.S. are extremely high it’s important to keep in mind that they are list prices that few people pay. Health insurance companies hire pharmacy benefit managers, who negotiate steep discounts. Even uninsured people often get manufacturer coupons, so they pay far less. A recent study found that on average there was a discount of 48% on Wegovy, for example (NN received $701 compared to $1,349 list price).

“My colleagues and I have studied the medical care costs of obesity.  The ‘cost offsets’ or savings potentially achievable through GLP-1s depend heavily on the starting weight of the patient. Patients with extreme or morbid obesity may see significant health care savings through their weight loss, but this is unlikely for patients who have overweight or even class 1 obesity.

“The cost of GLP-1 drugs is likely to drop sharply over time. The first generic GLP-1 is now available; it is cheaper than the brand-name version but will get even cheaper when it is out of its exclusivity period and other generics can enter.  Also, we now have two manufacturers of GLP-1s (Novo Nordisk and Eli Lilly), so price competition is likely. Finally, even more GLP-1s are in the development pipeline, and the more manufacturers are in this market the greater the price competition is likely to be.”

Adrienne Bitar

Lecturer of American Studies in the College of Arts and Sciences

Adrienne Bitar is an expert in the history and culture of American food and the author of “Diet and the Disease of Civilization” – the first full length study of diet books.

“A recent report found that Wegovy costs about $1300/month in the U.S., putting the drugs far out of reach for many Americans and pushing them to try risky, ineffective, and possibly dangerous ‘Ozempic dupes.’ High prices combined with poor regulatory oversight create a free-for-all grey market of supplements, home remedies, counterfeits, and ‘natural’ dupes that supposedly mimic the effects of semaglutides.”