IQVIA Predicts Spending on Obesity Drugs Could Reach $60 billion by 2029 | PBMI 2025

Scott Biggs

Obesity and diabetes treatments are reshaping the pharmaceutical marketplace, especially the GLP-1 agonists. They are the biggest contributor to the growth in drug sales, and four of the top five fastest-growing drugs by sales are the GLP-1 drugs Mounjaro, Zepbound, Wegovy and Ozempic, according to Scott Biggs, director of supplier services at IQVIA.

“The market is really driven by volume over the last 12 months, and we see the GLP-1s are the biggest contributor to growth in the marketplace,” he said during his keynote presentation at the Pharmacy Benefit Management Institute’s annual meeting today in Orlando. “They’ve really shaken up the market. We weren't even looking at this as a top category three years ago.”

Within the diabetes market, the GLP-1 drugs accounted for about 57% of the market by sales and 42% by prescription share. At the same time, sales of insulin products fell.

Most of the growth of the GLP-1 market is in the northeastern part of the United States, which Biggs said correlates to a higher median income. “And women are being dispensed twice as many weight loss GLP-1s as men. But it’s not the same on the diabetes side, where only about 30% of GLP-1 prescriptions are dispensed to women.”

Within the obesity market, spending could reach $60 billion in net manufacture costs by 2029 with a wide range of reimbursement and costs to patients. If there is significant expansion in usage and reimbursement, that number could reach $84 billion in net costs.

There are 181 obesity medications in development, with GLP-1 drugs and combinations accounting for 85 of these. In phase 3 trials alone, there are 16 new obesity drugs being studied

“We’re going to continue to watch how these perform,” Biggs said.

The growth in the volume of GLP-1 drug sales was just one of the many trends that Biggs presented from research done by the IQVIA Institute for Human Data Science. Other trends include

• Generics: While GLP-1s may dominate the conversation, generic drugs continue to be a huge part of the prescription drug market, accounting for 89% of prescriptions and 6% of sales. Biggs cited data from Nephron research that year that year-over-year sales deflation is about 5%. Looking forward, he said there are likely to be $91 billion in exclusivity losses, with the majority of those dollars being on the traditional side, compared with $27 billion on the biologic side.
• Biosimilars: Over the next 10 years, biologics will be losing their specificity, but there are few biosimilars in the pipeline for the higher-cost therapies. In fact, 59% of the biologics that will lose exclusivity in the next 10 years are low-sales biologics. “There might not be the savings we would hope to see from the biosimilars because we just don't have enough in the pipeline right now,” Biggs said.
• Novel therapies: More than half of new prescriptions for novel drugs are not filled by patients, and only 29% of patients remain on therapy after one year. “We’ve got to figure out a way to get the medicines in people’s hands and keep them persistent,” Biggs said.
• Cash sales: Cash sales on prescription drugs are the smallest segment. “I had an opportunity to talk to some independent pharmacists earlier this year, and one of the things that they told me is that when people come in with discount cards, they’re working with the patients to switch them over to cash to keep costs low for patients and to help their profitability a little bit better.”