Yale and the University of Florida: wider access to weight-loss drugs semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound) could save lives in the US

Researchers at Yale and the University of Florida report that making weight-loss drugs easier to obtain could markedly improve lives in the United States - and, in many instances, prevent deaths.

At today’s levels of availability, they estimate that 8,592 deaths are avoided each year, with the benefit falling largely among people with private insurance. The team calculates that broader access to prescriptions for medicines such as semaglutide (sold as Ozempic and Wegovy) and tirzepatide (Zepbound) - both increasingly used to support excess weight reduction - could cut annual US deaths by an estimated 42,027 additional people.

"Expanding access to these medications is not just a matter of improving treatment options but also a crucial public health intervention," says epidemiologist Alison Galvani of the Yale School of Public Health. "Our findings underscore the potential to reduce mortality significantly by addressing financial and coverage barriers."

Weight-loss drugs and access in the US

The analysis sits against the backdrop of an ongoing obesity crisis in the US. CDC figures indicate that 73.6 percent of American adults are overweight, defined as a body mass index (BMI) of 25 or higher. Within that, 41.9 percent meet the threshold for obesity, with a BMI of 30 or above.

Obesity is associated with a higher likelihood of numerous serious conditions - including cardiovascular disease, heart failure, liver disease, depression, cancer, stroke, and diabetes - each of which can shorten lifespan.

Mapping BMI and mortality

A research group led by epidemiologist and data scientist Abhishek Pandey of Yale University set out to estimate how widening access to weight-loss drugs might change US mortality from many obesity-linked diseases.

To do this, the scientists built a map showing how BMI is distributed across the US and compared it with the proportion of Americans who can currently obtain prescriptions for weight-loss medication. By combining these datasets, they aimed to quantify deaths from obesity-related complications that could be attributed directly to limited access to such prescriptions.

"Limited access stems from a combination of financial barriers, supply constraints, and restrictive insurance coverage," the researchers write in their paper.

"Although insurance typically covers these medications for diabetes treatment, coverage for weight-loss is less consistent, often requiring patients to pay out-of-pocket or face restrictive insurance policies. Furthermore, 25.6 million Americans are uninsured and more than 80 million are inadequately insured. Currently those uninsured with diabetes or obesity have no access to these innovative weight-loss drugs, and access is challenging even for those with coverage."

What expanded access could achieve

The team concludes that if everyone who met eligibility criteria for weight-loss prescriptions were able to obtain them, the US obesity rate would drop to 38 percent and more than 50,000 lives would be saved each year.

That projection reflects an ideal scenario in which price and supply do not limit access. Even so, the researchers estimate that progress short of that best case would still substantially reduce deaths from obesity comorbidities - including cutting deaths from type 2 diabetes by 11,769 people.

The study also points to the stark consequences of unequal access in a country that often presents itself as exceptionally wealthy. In the researchers’ view, that gap warrants targeted action.

"We need to ensure that drug prices are more aligned with manufacturing costs and increase production capacity to meet demand," explains mathematician Burton Singer of Yale University. "At the same time, we must tackle the insurance and accessibility issues that prevent many people from getting the treatment they need."

The research has been published in the Proceedings of the National Academy of Sciences.