Ozempic Still Costs $1,000 Per Month — But Its Cost Could Be As Low as $1

At this point, Ozempic is a household name — and its rent-like price tag is just as famous. One of the new class of GLP-1 drugs originally designed to treat diabetes (but came to viral stardom thanks to their side-effect of producing significant weight loss), Ozempic’s out-of-pocket list price is currently $935.77 per injectable pen according to its manufacturer, Novo Nordisk.

But according to a recent study published in March by The Journal of the American Medical Association (JAMA) and headed up by researchers from Yale, Harvard and Doctors Without Borders, most semaglutide GLP-1 agonists like Ozempic could cost as little as $0.75 to $72.49 per month. And that figure includes a tax allowance and a profit margin for the manufacturer.

Treating diabetes is expensive — and according to researchers, it doesn’t have to be

Using the market cost of active pharmaceutical units (with data from Jan. 1, 2016 to March 31, 2024) along with manufacturing operating expenses, researchers came up with cost-based prices (CBPs) for a variety of diabetes medicines. These CBPs were compared to the current market prices of each drug in 13 countries, including the U.S.

The study examines not only GLP-1 agonists, but also insulin and sodium-glucose cotransporter 2 inhibitors (SGLT2Is) like Brenzavvy (bexaglifloxin), Invokana (canagliflozin), Farxiga (dapagliflozin) and Jardiance (empagliflozin).

With the exception of human insulin products and the SGLT2i canagliflozin, every medicine studied could, according to the researchers, be made available at substantially lower prices. The CBPs of insulin analogues and insulin cartridges were, in some cases, respectively as much as 97% and 98% lower than current market prices.

"Across all insulins," the study reads, "the highest prices were in the US."

Novo Nordisk has yet to release a statement directly touching on Ozempic production costs. But the ongoing cost of production doesn’t include the drug’s substantial initial research and development costs — and this research comes in the midst of a long-running campaign to lower the cost of insulin, which may also affect the manufacturer’s business structure. (As of Jan. 1, 2024, as the Biden administration’s $35-per-month insulin cost cap took effect for Medicare subscribers, Novo Nordisk has lowered the list price of several of its insulin brands by up to 75%.)

In addition, the manufacturer has said in its most recent annual reports that it typically spends around 75% of its gross earnings on rebates and discounts that are meant to keep access to its semaglutide treatment accessible.

Still, as the researchers remark, Ozempic and other diabetes medicines "can likely be manufactured for prices far below current prices, enabling wider access."

Semaglutide for weight loss affects diabetes patients, too

Of course, not everyone is using (or hoping to use) semaglutide medications to lower their blood sugar. While Ozempic is still officially only approved to treat diabetes and its comorbidities, a similar drug, Wegovy, is now on-label for weight loss. (Wegovy is also manufactured by Novo Nordisk.)

Patients using GLP-1 treatments regularly see substantial weight loss that can be impossible to achieve or maintain with lifestyle changes alone: According to research collated by the Mayo Clinic, those using semaglutide lost an average of 33.7 pounds (as opposed to 5.7 pounds among those relying solely on diet and exercise).

According to Novo Nordisk, most people who take Ozempic don’t pay list price for the drug. Still, a total of about 9 million GLP-1 prescriptions were written by the end of 2022 — some 65.4% of which are for Ozempic, according to Trilliant Health’s 2023 Trends Shaping the Health Economy Report — some patients are almost certainly paying more than they can afford.

Although most insurance companies cover semaglutide medication for diabetes management, the promise of easy, rapid weight loss has caused a rush on the drugs — which has led some insurers to drop coverage for them as a treatment for obesity. Diabetes patients, too, have weathered delays in reimbursements for the drug as coverage collapses.

Experts remain mixed on whether or not the cost of Ozempic and similar drugs will naturally decrease over time in response to economic forces. Time, too, will tell whether the pressure this study places on Novo Nordisk will translate to lower out-of-pocket costs for hopeful patients.