Researchers estimate that 136.8 million adults in the U.S. are eligible for semaglutide, the generic for Novo Nordisk's Ozempic, Wegovy and Rybelsus.

In a study published Nov. 18 in JAMA, researchers from Beth Israel Deaconess Medical Center and Harvard Medical School, both based in Boston, and Chicago-based Northwestern University quantified the eligibility of the popular therapies.

Using a randomized sample of nonpregnant adults, they analyzed the prevalence of Type 2 diabetes, weight loss management and cardiovascular disease. Ozempic and Rybelsus treat diabetes, and Wegovy is for chronic weight management and cardiovascular events.

In those 136.8 million people, many conditions overlapped. About 22.8 million self-reported diabetes and either obesity (a body mass index of 30 or above) or diabetes and overweight (a BMI of 27 and above) with a weight-related comorbidity. The GLP-1 could also benefit 4.3 million people with managing cardiovascular disease and weight loss; plus another 4.5 million who have all three conditions.

The 2020 census counted 258.3 million adults in the U.S., meaning that about 53% of adults are eligible for semaglutide's indications.

This number of eligible adults exceeds the eligibility for statins (about 82 million), which are currently the most prescribed pharmaceuticals among U.S. adults.

"Although most of these individuals are eligible for semaglutide based on the weight-management indication that is not universally covered by payers, we estimate that more than 39 million adults qualify for indications other than weight management alone, a substantial increase over the estimated 15 million currently taking a GLP-1 receptor agonist," the researchers said.

Researchers also highlighted high costs as an access barrier since these therapies can cost about $1,000 each month without insurance. In 2023, semaglutide was the most utilized prescription medication in the U.S., accounting for $38.6 billion in pharmaceutical costs. If 50% of adults with obesity took a GLP-1 medication for weight loss, it would annually cost the nation $411 billion and bankrupt Medicare, according to the Senate Committee on Health, Education, Labor and Pensions.

Study authors concluded by saying affordability interventions for GLP-1s are urgently needed, as are efforts to increase equitable uptake.