GLP-1 therapies now drive nearly half of prescription drug sales growth, IQVIA's Scott Biggs told PBMI 2026 attendees, reshaping diabetes treatment and pharmacy dispensing economics nationwide.
Nearly half of the growth in prescription drug sales now can be attributed to glucagon-like peptide-1 (GLP-1) therapies. On the diabetes side, GLP-1s, including Mounjaro and Ozempic, make up a $98 billion market, with a 16.5% year-over-year growth. GLP-1 therapies for weight loss, including Zepbound and Wegovy, saw 75% year-over-year growth and generated $55 billion in sales in the past 12 months, which is up from $2 billion in 2022, said Scott Biggs, director of supplier services at IQVIA, at the keynote at the 2026 Pharmacy Benefit Management Institute (PBMI) annual meeting in Orlando.
The economics of which segments are filling these prescriptions has changed, Biggs said. Retailers, including independent pharmacies, are making very conscious decisions about whether to fill these prescriptions. For example, a year ago, approximately 48.5% of independent pharmacies were not filling prescriptions for GLP-1 for weight loss; now, 35% of independent pharmacies won’t fill weight loss GLP-1 prescriptions and 8% won’t fill prescriptions for diabetes GLP-1s. “Independents are starting to embrace the weight loss GLP-1s,” he said.
Approximately 80% of the GLP-1 market is being sold through retail pharmacies, but Biggs said mail delivery is increasing as direct-to-consumer options, although small, become more popular. Mail delivery now accounts for 12.9% of GLP-1 prescriptions.
The growth of the GLP-1 category has also reshaped the diabetes market. Sales of insulin products have slowed for 2026. Insulin made up just 9.8% of the diabetes market in June 2026, down from 38.4% in 2021. In terms of the number of prescriptions, insulin products account for 16% of prescriptions filled, down from 21% in 2021.
Biggs said he is beginning to see sizeable demand for GLP-1 therapies for weight loss through
“In the first three days, we showed 9,000 claims paid. By my estimates, that would be almost $2 million paid for by CMS,” he said.
Biggs expects both sales and the number of prescriptions of GLP-1 products to increase as new therapies become available and are approved for other indications. The pipeline for GLP-1 products has expanded beyond obesity and diabetes, with approximately 200 molecules in development, Biggs said.
"There are also some emerging frontiers going on in this area,” he said during his presentation. “One that we’ve been talking about is mental health. There are some trials that suggest there are some possibilities for GLP-1s to improve some depressive symptoms. I’ve heard a lot about substance use disorders. There are links found between the GLP-1s to reduce alcohol consumption, opioid overdose risk and tobacco use.”
In the short term, the GLP-1 pipeline is evaluating therapies that could minimize side effects to improve tolerability, maintain muscle mass and achieve greater weight loss, either alone or in combination.
Longer term, Biggs said, researchers are also exploring GLP-1 therapies for decreasing the risk of prostate cancer progression, endometrial cancer and some obesity-related cancers; addressing women's health for fertility and ovulation and polycystic ovary syndrome; and addressing systemic inflammation for respiratory disease and neurodegenerative diseases, such as dementia and Alzheimer’s disease.
“This will be an interesting category to watch to see how the market goes,” he said. “Obesity can be linked to many other things in a person's system. Researchers are talking about immune pathway overlap, plasticity and whether it alters the immune disease phenotype; some weight-dependent pharmacology; microbiome dysbiosis; and biomechanical stress.”
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