GLP-1 drugs and the 2025 US health bill

Americans spent $5.7 trillion on health care in 2025, a 7.3% rise from 2024, and federal actuaries say weekly weight-loss and diabetes injections are one of the reasons the bill keeps climbing^[1]. The figure works out to almost $16,500 per person, and the same projection has the country on pace to pass $6 trillion in 2026^[1]. The drugs in question are the GLP-1 receptor agonists, the class that includes semaglutide and tirzepatide. Here is what the spending numbers actually say, and what they do not.

Where the 2025 number comes from

The $5.7 trillion estimate is from the Centers for Medicare and Medicaid Services Office of the Actuary, the federal team that tracks national health expenditure each year. Its latest projection was published in the journal Health Affairs on 24 June 2026 and reported by STAT News and Healthcare Dive^[2]. The 7.3% growth rate marks the third year running that national health spending has risen faster than 7%. CMS deputy director John Poisal told Healthcare Dive that prescription drugs were a leading driver and put it plainly: "A big, big part of this is GLP-1s, and that is pushing growth rates up."

GLP-1, short for glucagon-like peptide-1, is a gut hormone that helps regulate blood sugar and appetite. The receptor agonists are laboratory-made peptides that mimic it. They were first approved for type-2 diabetes and later for chronic weight management, and demand for both uses has grown faster than budget analysts expected. We cover the individual molecules on the peptide library.

Two things stack on top of each other in a number like $5.7 trillion. People are using more care across the board, seeing doctors and filling prescriptions more often than forecasters anticipated, and a specific set of expensive drugs is growing inside that wider increase. The actuaries describe weight-loss drugs as having become their own category of spending. That is why the GLP-1 story and the broader health-cost story are talked about together, even though the drugs are only one line in a much larger budget.

How big is GLP-1 spending on its own

A research letter in JAMA Network Open put a number on it. Spending on GLP-1 receptor agonists among US adults rose from $13.66 billion in 2018 to $71.66 billion in 2023, an increase of more than 500% in five years^[3]. Most of that came from a single molecule: semaglutide sold as Ozempic went from $0.41 billion in 2018 to $26.42 billion in 2023, and the obesity version sold as Wegovy reached $6.99 billion by 2023.

Government programmes feel the same pressure. KFF reports that gross Medicare Part D spending on GLP-1 drugs reached $27.5 billion in 2024, a fivefold increase from 2019, across roughly 21.8 million prescription claims^[4]. KFF notes that net spending after manufacturer rebates is much lower, which is the gap the headline figures tend to hide.

What the spending number does not tell you

A rising spending line is not the same as a rising price per pen, and it is not a verdict on whether the drugs are worth it. The JAMA Network Open letter is explicit that its dataset excluded compounding pharmacies and could not adjust for rebates, discounts or price concessions^[3]. Most of the growth reflects more people taking the drugs rather than each prescription costing more. Cost-effectiveness, long-term safety and who should be treated are separate clinical questions that a single expenditure total cannot settle.

The KFF Medicare figures make the same point in a different way. The $27.5 billion gross total for 2024 sits alongside an estimate that manufacturer rebates run near half of that, so the amount Medicare actually pays is well below the sticker number^[4]. Gross and net are easy to confuse, and a lot of GLP-1 cost coverage quotes the larger one.

The CMS projection also expects this growth to cool. Actuaries forecast Medicare prescription drug spending growth slowing later in the decade as GLP-1 use stabilises and drug-price negotiation takes effect^[2]. A 2025 or 2026 snapshot is a moment in a longer arc, not a permanent trend. The same is true of the science: the head-to-head and long-term data on tirzepatide and the rest of the class is still being published.

Where this sits for readers

If you are trying to understand why GLP-1 drugs keep making headlines, the spending data is one half of the story and the clinical evidence is the other. For the drugs themselves, see semaglutide, tirzepatide and the investigational triple agonist retatrutide. For where each one is legal and how it is classified by country, start at the regulation hub. The money is one signal among several, and it is not a reason to start or stop any treatment on your own.