CVS Health Study: GLP-1 Drugs Could Break Even for Health Plans Below $350 a Month
CVS Health on November 14 released a study based on claims data from its Aetna health insurance unit saying employers and other health plan sponsors could break even on GLP-1 drugs if they were priced below $350 per month, as reduced use of medical services such as hospitalizations and emergency room visits would lower spending enough to offset drug costs.
The analysis compared patients who newly started GLP-1 medicines from Eli Lilly and Novo Nordisk between 2023 and 2025 with similar patients who did not take the drugs, covering Mounjaro and Ozempic for diabetes and Zepbound and Wegovy for obesity, over periods of up to three years. CVS said GLP-1 use was associated with 10-12% lower emergency room visits in the first and second year of use, and an analysis of records for 4,000 people still taking the drug after three years showed hospitalizations down 34-42%. Across those three years, plan sponsors saved $9,400 per person on medical bills but spent $13,300 more on prescriptions, adding $3,900 per person in net costs at current prices.
Dr. Amy Compton-Phillips, chief medical officer at CVS Health, said the drugmakers' direct-to-consumer prices suggest they can still profit by charging less than $350 a month while helping lower overall healthcare costs, and said she hoped that price could be reached sooner rather than later. CVS was set to present the findings on November 15 at the HLTH USA conference in Las Vegas.
(Source: CVS Health)
Source: CVS Health
Published by GSM · USA (original Chinese edition)
Photo: 图：位于加州 Oakland 的一家 CVS Pharmacy 门店。Thomasfan1916 摄，CC BY-SA 4.0，经 Wikimedia Commons。 / Photo: A CVS Pharmacy store in Oakland, California. Photo by Thomasfan1916, CC BY-SA 4.0, via Wikimedia Commons.
