TL/DR –
U.S. spending on prescription drugs is projected to surpass $1 trillion in 2026, largely due to the popularity of weight-loss and diabetes drugs tirzepatide and semaglutide, according to the American Society of Health-System Pharmacists. Sales of these weight-loss drugs have continued to increase even as manufacturers Lilly and Novo cut prices to attract more customers, with nearly half of employer insurance plans covering the anti-obesity drugs. Medicare announced a program to begin coverage of these weight-loss drugs from July 1 through Dec. 31, 2027, and overall drug spending is rising due to greater use by consumers and patients.
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GLP-1 Weight Loss Drugs Boost Prescription Sales Towards $1 Trillion Mark
The surge in the sales of GLP-1 weight loss drugs is potentially driving the United States towards spending over $1 trillion on prescription drugs this year, according to a new report.
U.S. spending on prescription drugs in 2025 leaped by approximately 13% to $915 billion and is estimated to exceed $1 trillion in 2026, reveals a report released on April 30 by the American Society of Health-System Pharmacists (ASHP).
GLP-1 weight-loss and diabetes drugs, tirzepatide and semaglutide, are key drivers behind this growth. Tirzepatide, sold by Eli Lilly as Zepbound for weight loss and Mounjaro for treating Type 2 diabetes, was the highest selling drug in the nation. In 2025, it generated $63 billion in wholesale purchases, as per the ASHP report.
Novo Nordisk’s semaglutide, marketed as Wegovy for weight loss and Ozempic for treating Type 2 diabetes, came in second with over $59 billion in sales last year. The No. 3 drug, Eliquis, a blood thinner, only recorded $29 billion in sales, which is less than half the amount spent on each of the weight-loss drugs.
Lower Prices for Consumers, More Revenue for Drug Companies
Even as the weight-loss drugs Zepbound and Wegovy saw price cuts from manufacturers Lilly and Novo to attract more customers who pay out-of-pocket, their sales continued to hike. According to surveys, employer insurance plans cover nearly half of these anti-obesity drugs. Both companies have also sought to draw in uninsured consumers by selling these medications directly through their own pharmacies or via telehealth providers.
Eric Tichy, the lead author of the ASHP report and chair of supply chain management at Mayo Clinic, remarks on the public’s demand for GLP-1 drugs, stating that “they are a phenomenon.” He attributes their success to their weight-loss properties and the ongoing obesity epidemic in the U.S.
In light of the popularity of GLP-1 drugs, spending trends are expected to rise with the launch of new weight loss pills this year – Novo’s Wegovy and Lilly’s Foundayo.
Lilly CEO David Ricks has noted that price reductions for these popular weight-loss drugs have driven sales upwards. He also maintains that it’s vital to expand insurance coverage for these anti-obesity drugs.
An important development occurred earlier this month when Medicare announced a bridge program to cover GLP-1 weight-loss drugs from July 1 through Dec. 31, 2027, with enrollees paying a $50 monthly copay to receive the medications.
Growing Prescription Drug Use Fuels Cost Increase
The ASHP report estimates that U.S. spending on prescription drugs will rise by 10 to 12% this year to surpass $1 trillion.
In addition to the growing sales of GLP-1 drugs, the overall drug expenditure is increasing due to higher usage by consumer and patients. Higher drug prices only account for 1% of overall drug spending, according to the report.
On the other hand, other reports indicate that drug price increases are quite frequent. For example, data from 46brooklyn Research, a drug pricing nonprofit, reveals that companies raised list prices on more than 850 drugs by a median 4% over 2025. However, some widely used drugs such as Eliquis and Jardiance saw significant price reductions by 43% and 44% respectively, as per 46brooklyn.
Changes to Medicare’s coverage policies could also be contributing to the growing use of prescription drugs, suggests Tichy. In 2026, Medicare implemented a $2,100 cap on out-of-pocket drug spending for older Americans in Medicare Part D, which covers pharmacy or mail-order prescriptions. This cap is part of the Inflation Reduction Act, the 2022 federal climate and healthcare bill that also enabled Medicare to negotiate drug prices with pharmaceutical companies.
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