For the first time, traditional drug spending has exceeded specialty drug spending, largely due to the demand for GLP-1s, according to a new report from Evernorth Research Institute.
Evernorth Research Institute analyses anonymized clinical and administrative data to understand trends and challenges affecting healthcare. Its new report, called the 2025 Pharmacy in Focus Report, is based on data collected from scientific literature, pharmacy claims, industry reports and stakeholder surveys.
Traditional drugs are used for common health problems like infections, high blood pressure, diabetes and high cholesterol. In the past, their costs have remained stable since they’re broadly accessible and easier to manufacture than specialty drugs. However, the approval of semaglutide for chronic weight management in 2021 changed things.
The annual growth rate of spending for traditional drugs increased from 2.1% in 2021 to 12.8% in 2024. This compares to specialty, which had an annual growth rate of 5% in 2021 and 4.9% in 2024.
Evernorth also found that drugs for weight management represented 46.8% of the total increase in drug spend in 2024. The researchers anticipate GLP-1 demand to continue to rise, with a projected 73.1% increase in utilization for weight loss in 2025.
In addition, there are also questions about the value of GLP-1s in the long term. About half of patients using GLP-1s for weight loss stop within a year. Their reasons for stopping include side effects and financial and insurance barriers.
“While high costs may play a role in discontinuation, cases where side effects prompt patients to stop treatment should raise concerns for plan sponsors about the significant upfront investment required to initiate these therapies,” Evernorth said.
GLP-1s are also gaining popularity among younger generations. Gen Alpha (14 and under) leads the rise in GLP-1 usage with an 84.6% increase from 2023 to 2024, followed by Gen Z (15-28) at 67.8% and millennials (29-43) at 47.7%.
“Early adoption of costly treatment can create an unsustainable burden on health plans, employers and communities because of potential lifelong reliance and the related comorbidities of these costly treatments,” according to the report.
Looking ahead, GLP-1s are also being considered for numerous other conditions like cardiovascular disease, chronic kidney disease and Alzheimer’s. This could lead to further demand for the drug and add to the challenges of covering the drug, Evernorth stated.
To combat these challenges, the report provides several recommendations for healthcare stakeholders. This includes using real-world data to improve prescribing guidelines and prioritizing prevention and lifestyle strategies, such as strengthening school nutrition and physical activity programs.
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