Key takeaways:
Despite high demand for GIP and GLP-1 agonists due to their weight-loss benefits, commercial insurance coverage has not improved across the board in 2025. In fact, coverage has become even more restrictive for several popular medications.
The number of people with no commercial insurance coverage for Zepbound increased by over 180% in 2025, leaving over 97 million people with no coverage. For those who have insurance coverage, over 90% still have to meet additional requirements like prior authorization.
Despite increased coverage for Wegovy in 2025, 88% of people with coverage still face restrictions like prior authorization or step therapy. And 19 million people lack coverage for any GIP and GLP-1 agonists prescribed for weight loss.
Demand for the GIP and GLP-1 agonists that can cause weight loss has continued to climb in the new year. However, insurance coverage has yet to catch up.
The GoodRx Research team is tracking commercial insurance coverage for popular GIP and GLP-1 agonists that have weight-loss benefits, including:
Tirzepatide (Zepbound for weight loss, Mounjaro for Type 2 diabetes)
Semaglutide (Wegovy for weight loss, Ozempic for Type 2 diabetes)
Liraglutide (Saxenda for weight loss, Victoza for Type 2 diabetes)
We’ll regularly update the chart below to track any potential changes in access to these in-demand medications.
How does insurance coverage affect access?
Prescription drug coverage determines how much people pay out of pocket for their medications. We grouped commercial insurance plans into three categories of coverage:
Unrestricted coverage: People in health plans with unrestricted coverage can use their insurance right away to help pay for their prescription. Out-of-pocket costs are usually a portion of the total cost. This is the most accessible form of insurance coverage.
Restricted coverage: People in health plans with restricted coverage need to meet additional requirements in order to use their insurance to help pay for their prescription. These extra steps can include getting approval or “prior authorization” from their insurance, trying a different medication first (also called “step therapy”), or both. While people with restricted coverage can access their medication at a more affordable price, they may face delays and other administrative burdens along the way. To avoid dealing with these restrictions, some may forgo using insurance and pay full price, or abandon their prescription altogether.
No coverage: People in health plans with no coverage of their medication must cover the full cost of their prescription. This means that people who want to fill their weight-loss prescription may face high out-of-pocket costs, which can exceed $1,300 every month — even if they have health insurance.
Keep in mind that insurance coverage doesn’t account for deductibles, which have become increasingly common. Some people have a separate deductible that applies only to prescription medications. This means they will pay full price on medications until they meet their pharmacy deductible. On top of that, many Americans are caught in a “Big Pinch” as insurance plans cut back on coverage and place more restrictions on the medications that are covered.
Changing insurance coverage
Despite the growing list of medical benefits for GIP and GLP-1 agonists, including weight loss, commercial insurance coverage has yet to catch up to demand.
So far in 2025, Zepbound has already seen notable shifts in commercial insurance coverage. As of July 2025, CVS Caremark removed Zepbound from their standard formulary. That means that since 2024:
The share of people with unrestricted coverage fell from 9% to 5%, reducing access to Zepbound.
There was an even larger drop in restricted coverage, which fell from 73% to 45%.
As a result, the number of people with no coverage increased from 18% to 51%, leaving over 97 million people with no insurance coverage for Zepbound (an additional 62 million people since 2024).
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Altogether, these changes in coverage make Zepbound less accessible to the general population.
Meanwhile, access to Wegovy, another medication prescribed specifically for weight loss, has improved slightly compared to last year. This is in part due to CVS Caremark’s decision to prefer Wegovy on their standard formulary. Since 2024:
The number of people with unrestricted coverage declined from 14% to 10%, reducing unrestricted access to Wegovy.
However, the number of people with restricted coverage rose from 67% to 75%.
As a result, over 6 million people gained some form of commercial insurance coverage for Wegovy in 2025.
Despite this improvement, over 28 million people still lack commercial insurance coverage for Wegovy.
In 2025, overall coverage has shifted to a lesser degree for Ozempic and Mounjaro, GIP and GLP-1 agonists used to treat Type 2 diabetes. While over 1.8 million people gained coverage for Mounjaro, over 660,000 people still lack coverage. Commercial insurance coverage for Ozempic, the most-filled GLP-1 agonist, has remained largely the same, with nearly 5 million people who lack coverage.
With the introduction of generic liraglutide, commercial insurance coverage has also worsened for brand-name Victoza and Saxenda in 2025. The number of people without insurance coverage has increased by 120% and 49%, respectively.
In 2025, at least 23 million people gained coverage for generic liraglutide. However, at least 41 million people lost coverage for Victoza, and over 16 million people lost coverage for Saxenda. As a result, millions of people still lack insurance coverage for liraglutide. This is particularly true for Saxenda, which is the only brand of liraglutide prescribed specifically for weight loss.
Altogether, nearly 10% of people with commercial insurance — about 19 million people — lack coverage for any of the GIP and GLP-1 agonists prescribed for weight loss in 2025. That means if they are prescribed Wegovy, Zepbound, or Saxenda, their insurance will not cover it.
Rising restrictions
Increased restrictions for many GIP and GLP-1 agonists has further limited access to these medications.
Restrictions continue to limit the vast majority of commercial insurance coverage for GIP and GLP-1 agonists prescribed specifically for weight loss. This means there are restrictions on insurance coverage for Wegovy, Zepbound, and Saxenda for over 88% of people. Even when GIP and GLP-1 agonists are prescribed for Type 2 diabetes, additional restrictions are usually placed on insurance coverage — 77% of the time for Mounjaro and over 81% of the time for Ozempic.
Many of the medications that saw coverage changes in 2025 have also seen more restrictions. Compared to 2024, here’s how restrictions have played out:
Wegovy: 7% more people face restrictions on their insurance coverage for Wegovy.
Ozempic: 11% more people face restrictions on their insurance coverage for Ozempic.
Victoza: 29% more people face restrictions on their insurance coverage for Victoza.
While generic liraglutide has fewer insurance restrictions compared to brand-name medications, coverage has also become increasingly restrictive in 2025:
Liraglutide: Since 2024, 18% more people face restrictions on their insurance coverage for generic liraglutide.
As a result, more people need to jump through extra hoops to access these medications, despite having insurance.
Savings tips
People without insurance coverage can still save on the full retail price through prescription discount programs like GoodRx.
GoodRx can save people an average of $281 per month on semaglutide, tirzepatide, or liraglutide. These savings add up to an average of $3,000 annually.
Co-contributors: Trinidad Cisneros, Ph.D.
Methodology
We sourced prescription insurance coverage from Managed Markets Insight and Technology, LLC™, a trademark of MMIT. Data reflect the average share of commercial and health exchange covered lives with insurance coverage across all available forms and dosages of each medication.
References
CVS Health. (2025). Improving access and affordability to high-cost weight management drugs.
KFF. (2024). 2024 employer health benefits survey.
KFF. (2014). Medical and prescription drug deductibles for plans offered in federally facilitated and partnership marketplaces for 2015.
Munz, K. (2025). FDA expands semaglutide use for CV, kidney risks in T2D, CKD. The American Journal of Managed Care.
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