About 3.8 million people in the United States — four times the number two years ago — are now taking the most popular weight-loss drugs, according to the IQVIA Institute for Human Data Science, an industry data provider.
Some of these prescriptions are for diabetes. The medicines are Novo Nordisk’s Ozempic and Wegovy (the same drug sold under different brand names), and Eli Lilly’s Mounjaro and Zepbound (also the same drug).
Pent-up demand is even higher, because many people who want the drugs cannot find or afford them. Without insurance coverage, people have to pay out of their own pockets. If they obtain a coupon offering a discount from Eli Lilly, people with commercial insurance pay $550 a month for Zepbound. For those who are commercially insured, a coupon from Novo Nordisk for Wegovy reduces the pharmacy bill by $500, making the cost roughly $1,000 a month.
And the interest is expected to keep growing.
2. The supply is limited.
Novo Nordisk and Eli Lilly have tried to respond by ramping up production, but they have not been able to churn out enough to come close to meeting demand.
Only a limited number of plants in the world are ready and available to make the injectable drugs, which are harder to manufacture than pills. Adding to the complexity, each company is manufacturing at least five dosage strengths of its drug.
“These are complicated sites, really technically demanding work, very capital intensive, populated with machines that are highly specialized and often made in not-so-big companies,” Eli Lilly’s chief executive, David Ricks, said last month.
For Eli Lilly, which sells Zepbound for weight loss, a crucial bottleneck has been making enough of the pens that are used to inject the drug.
Novo Nordisk, the manufacturer of Wegovy, has struggled even more than Eli Lilly to make enough of its drug, though it is trying to catch up. It said that in January it more than doubled the supply of doses for new patients, estimating the medication would reach pharmacies within a couple of weeks.
This situation is unusual, said Erin Fox, an expert at the University of Utah who tracks drug shortages. Most scarcities involve older medications in which there is little financial incentive to manufacture the drugs. “Usually if there is a very profitable drug, we don’t see shortages,” she said.