New research shows 52% decrease in GLP-1 utilization for weight loss from 2025 to Q1 2026
BOSTON — Today, the Massachusetts Health Policy Commission (HPC) Board previewed new data on GLP-1 drug trends, to be included as a chapter of the Office of Pharmaceutical Policy and Analysis’s (OPPA) upcoming Annual Report.
OPPA, established within the HPC by Chapter 342 of the Acts of 2024, shared new GLP-1 research analyzing data through Q1 2026. The HPC found that spending and utilization dropped significantly as many commercial insurers discontinued coverage of GLP-1s for weight loss. In Q1 2026, an estimated 112,000 fewer commercially-insured members utilized a GLP-1 drug for weight loss – a 52% decline from 2025 – which is expected to contribute to reduced spending in 2026.
In recent years, the GLP-1 market has been evolving rapidly in Massachusetts and nationwide. New research has suggested GLP-1 drugs can be used for a range of conditions, several new drugs have entered the market, and manufacturers have increased direct-to-consumer sales. These new options for broader use have been counterbalanced by coverage and access changes, including several Massachusetts health insurance plans discontinuing coverage for GLP-1 drugs prescribed for weight loss for many members in 2026.
Net prices after manufacturer rebates and discounts for GLP-1 drugs have declined as new drugs entered the market. Between 2019 and early 2026, average net prices for GLP-1s for diabetes declined by 30% and for GLP-1s for weight loss by 43%. Since utilization of GLP-1s for weight loss started to significantly increase in 2023, average net prices for these drugs have declined by 18%.
“In just a short amount of time, GLP-1 drugs have had an enormous impact on the Massachusetts health care system,” said HPC Chair Deborah Devaux. “The HPC will continue to monitor the rapidly evolving GLP-1 market to better understand broader impacts on the health care market, and on residents’ ability to access the medication that they need.”
“GLP-1 drugs have had a demonstrated value to the patients who utilize them and could potentially play an important role for the health system at large through improved health outcomes and long-term health benefits,” said HPC Executive Director David Seltz. “At the same time, we must consider affordability and access, and the impact of the cost of these drugs on the overall health care system. In recent years, retail drug spending has become one of the fastest areas for spending growth in the Commonwealth, with accompanying effects on patient affordability through increases in cost-sharing. The HPC’s Office of Pharmaceutical Policy and Analysis will explore these trends in more detail, with a focus on making pharmaceutical access sustainable and affordable for all of the Commonwealth’s residents.”
Key Findings:
- GLP-1 spending and utilization:
- In 2025, net spending in the Massachusetts commercial market reached ~$1 billion with ~300,000 members utilizing a GLP-1 drug. Gross spending on GLP-1 drugs (before manufacturer rebates and discounts) reached over $2.3 billion in 2025.
- Spending on GLP-1s drugs for weight loss grew at an average annual rate of 99.5% over the 2019-2025 period.
- The estimated number of commercially-insured residents utilizing a GLP-1 drug for weight loss grew significantly: from 3,300 in 2019 to 216,000 in 2025.
- Four GLP-1 drugs from Novo Nordisk and Eli Lilly (Ozempic, Wegovy, Mounjaro, and Zepbound) have generated net sales of $2 billion in the Massachusetts commercial market, and over $125 billion in the U.S. across all payers since launch.
- Spending and utilization dropped significantly in Q1 2026 as coverage changed. 112,000 fewer commercially insured members utilized a GLP-1 drug for weight loss, a 52% decline from 2025.
- Pricing: As new drugs entered the market between 2019 and Q1 2026, manufacturer rebates and other discounts grew. As a result, average net prices of GLP-1 drugs have declined over the 2019 to Q1 2026 period (43% decline for drugs prescribed for weight loss and 30% decline for drugs prescribed for diabetes). Since utilization of GLP-1s for weight loss started to significantly increase in 2023, average prices for these drugs have declined by 18%.
- Patient cost sharing: Most claims (~90%) required copays. In 2025, monthly cost sharing averaged $66 for GLP-1 drugs for diabetes and $78 for GLP-1 drugs for weight loss.
- Declining commercial coverage of GLP-1s for weight loss: Many payers in Massachusetts discontinued coverage of GLP-1s for weight loss in 2026, including Blue Cross Blue Shield of Massachusetts, Point32, and Mass General Brigham Health Plan. The Group Insurance Commission (which covers state employees) and MassHealth also discontinued coverage of GLP-1 drugs for weight loss beginning July 2026.
- Increasing direct-to-consumer sales of branded GLP-1s: Nationally, one in six adults obtain GLP-1 drugs through online direct-to-consumer channels. Self-pay now accounts for 35% of Novo Nordisk’s Wegovy sales and 45% of Eli Lilly’s Zepbound prescriptions, with annual direct-to-consumer costs for maintenance doses totaling $4,188 for Wegovy and $5,388 for Zepbound.
- GLP-1 drug pipeline: 39 new branded GLP-1 drugs are in development from 34 companies, with 12 new GLP-1s expected to launch by 2030. Generic versions of the blockbuster GLP-1s, however, are not expected until 2041, though generic Ozempic and Wegovy launched in Canada and other international markets in 2026.
- Repricing analysis: If commercial health plans paid CMS negotiated prices or international reference prices, spending on GLP-1s in Massachusetts would have decreased significantly in 2025. If blockbuster GLP-1 drugs were repriced in 2025 to CMS negotiated prices, GLP-1 spending would have decreased by 32% (reducing pharmacy spending in the commercial market by 4.7%; total commercial health care spending by 1.0%) and by 61% if repriced to international reference prices (reducing pharmacy spending in the commercial market by 9.0%; total commercial health care spending by 1.8%).
More will be shared in the Office of Pharmaceutical Policy and Analysis’s first Annual Report, forthcoming this winter. A recording of the HPC Board meeting and presentation materials are available on the HPC’s website.
