Insurer Strategies to Control Costs Associated with Weight Loss Drugs

Affordable Care Act (ACA) Marketplace plans rarely cover GLP-1 drugs approved solely for obesity treatment, according to a an analysis of 2024 federal plan data. Wegovy, a drug that is approved for weight loss, is covered by just 1% of Marketplace prescription drug plans, compared to 82% of Marketplace prescription drug plans for Ozempic, which contains the same active ingredient as Wegovy (semaglutide) but is approved only for diabetes.

This analysis examines publicly available formularies of plans available on the federally facilitated ACA Marketplaces in 2024 and does not include states that run their own Marketplaces, where coverage patterns may differ. The ACA Marketplaces represent a small share of people with private health insurance, as most people with private coverage have plans sponsored by their employers.

The full chart collection and other data on health costs are available on the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.