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list prices (2025): $900$1,300 per month without insurance $11,000$16,000 per year at retail pricing Manufacturer coupons typically expire after 612 months Coverage reality: Medicare: limited obesity coverage Medicaid: varies by state Employer plans: increasingly restrictive prior authorization Weight regain often occurs after discontinuation Projected pricing trends: Near-term (35 years): modest price erosion, not collapse Medium-term (510 years): biosimilars and next-gen entrants may reduce prices 3050% Long-term: combination therapies likely raise per-patient spend again This is not a short-course drug market

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