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Doctors advise most patients on GLP-1 obesity drugs such as Wegovy and Zepbound to stay on them to keep the weight off, but as more U.S. insurers restrict coverage people are trimming costs by stretching doses or forgoing expenditures like vacations to pay for the medication out of pocket. A half dozen doctors who spoke with Reuters said insurance coverage has tightened in 2025 as many employers drop it for the expensive GLP-1 drugs. While patients on these medications are counseled on proper diet and exercise, clinical trials show that people who stop taking these drugs are apt to regain weight. Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound are weekly injections with U.S. insurer list prices of more than $1,000 a month. For customers willing to pay cash, both drugmakers will ship directly for $499 a month if refills are purchased at fixed intervals. “A significant number of my patients now pay cash,” said Dr. Nidhi Kansal, an obesity specialist at Northwestern Medicine in Chicago. “People find a way to scrounge up $6,000 a year, which sucks, because that’s a vacation or two.” More than a billion people worldwide are obese, according to the U.N. World Health Organization, which has said the GLP-1 drugs could help end the obesity pandemic. ‘A KIND OF PURGATORY’ A tech industry job change for Yelena Kibasova, a 40-year-old who lives in the Minneapolis area, meant loss of coverage for her Zepbound prescription that helped her achieve and maintain a 150-pound (68-kg) weight loss. GLP-1 patient Yelena Kibasova, 40, poses in this undated handout picture. [Photo: @morethanmyweight/Handout via Reuters] “My new company does not cover GLP-1s, so now I am in a kind of purgatory,” Kibasova said. “I stopped doing my nails. I stopped doing my hair. Those things are not as important as me staying at a healthy weight.” The doctors interviewed by Reuters said patients once leery about long-term obesity treatment are now more comfortable staying on a drug. The doctors said that conversations about temporary use happen only when a patient is trying to lose a certain amount of weight for issues such as fertility treatment or an organ transplant. These obesity specialists said they are hopeful that competition will help bring down prices as new weight-loss options emerge, including new oral drugs that may be available next year. Lilly last week announced trial results for its easier-to-manufacture pill, which was shown to cut patient weight by 12.4%, a few percentage points less than injected drugs. The company hopes to launch it in August 2026. Kenneth Custer, Lilly’s head of cardiometabolic health, told Reuters the pill is being tested in several settings, including as a maintenance therapy. Custer declined to comment on how it might be priced. MEDICATION FOR MAINTENANCE Dr. Anne Peters, an endocrinologist at Keck Medicine USC in Los Angeles, said it is important that patients who reach their weight-loss goal not stop a prescription “cold turkey,” so the dose can be tapered down over several months. Peters said about a third of her patients are able to reduce their dose and maintain weight loss, while the rest need to stay on the medication. An analysis of U.S. pharmacy insurance claims found that nearly two-thirds of patients who started on Wegovy or Zepbound in 2024 were still on the medications a year later. Peters said she uses “every technique in the book” to secure insurance coverage for patients, but noted that a growing number of plans no longer pay for the treatments, and patients have to pay out-of-pocket. U.S. pharmacies supply self-injection pens pre-loaded with doses of Wegovy or Zepbound. Lilly’s direct-to-consumer service also offers vials. “Some patients can stretch out the vials longer. Get 15 mg, and then give a 10 mg dose for instance,” Dr. Peters said, noting that the drug’s instructions advise that such an approach should not be taken. Doses of 5 mg, 10 mg and 15 mg are recommended for weight-loss maintenance. Patients also are turning to lower-cost compounded versions of the GLP-1 drugs, or are even mixing them at home with raw ingredients, both of which Peters and other doctors advise against due to safety concerns. Dr. Angela Fitch, former president of the Centennial, Colorado-based Obesity Medicine Association and chief medical officer at online primary care provider Knownwell, said nobody wants to be on a medication, but patients who respond to a GLP-1 drug “really don’t want to go off of it when they recognize that it has such a value to them.” Both Wegovy and Zepbound were first launched, under the brand names Ozempic and Mounjaro, as diabetes treatments. The class has been linked to a range of benefits, including improved heart health and less sleep apnea. Fitch said the most common reason for her patients to stop taking a GLP-1 drug is loss of insurance coverage. She said her experience is that about 10% of patients are able to reach a target weight and maintain it without further treatment. “We are in a dip where people are dropping coverage,” Fitch said, adding that the direct-to-consumer options are an “upper-ish middle-class thing.” Deena Beasley, Reuters
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E-Commerce
Back-to-school season is officially upon us, and with it comes the usual influx of ad campaigns and last-minute trips to Target. This year, though, some parents are sensing a shiftand theyre sharing how back-to-school shopping is starting to feel untenably expensive. On TikTok, several creators have voiced their concerns that back-to-school prices are becoming shockingly high this year, with some creators finding a pack of pencils for as much as $21 and Post-its for $19. These reports come after the Trump administrations second major round of tariffs on more than 60 countries came into effect on August 7. Now, parents are rushing to get their shopping done earlier than ever as potential price hikes loom. Parents report rising back-to-school prices According to a July report from the National Retail Federation (NRF), two-thirds of back-to-school shoppers had already begun purchasing items for the upcoming school year as of early Julythe earliest start on the NRFs record. The NRF expects the average household to spend just under $860 on back-to-school shopping for K-12 students. Consumers are being mindful of the potential impacts of tariffs and inflation on back-to-school items, and have turned to early shopping, discount stores and summer sales for savings on school essentials, Katherine Cullen, NRF vice president of industry and consumer insights, noted in the report. Indeed, school supplies are one of the categories that experts expect to be hit the hardest by tariff-related price jumps. In an analysis published on August 5, the U.S. Chamber of Commerce examined Census Bureau data for May and June of this year and compared it to the same months last year, aiming to identify which product categories are bearing the brunt of tariff-based tax increases so far. It found that, over the past year, tariff rates on typical back-to-school items like pens, pencils, and folders jumped from an average rate of 5% to 18%, while tariff rates on clothing and shoes have jumped from 14% to over 25%. While much of this burden has been shouldered by wholesalers and manufacturers, the months ahead will see a larger share of these costs passed on to consumers, the reports author, Neil Bradley, wrote. Americans are paying the tariffs, but not all these costs are being passed onto consumersat least, not yet. Customers are taking to TikTok to express fears that big-box retailers might be actively raising prices on back-to-school related items. Several creators have specifically noted discrepancies between tag prices and display prices on clothing items at Walmart or tags with no prices altogether, with some speculating that tariff-related price hikes could be to blame. For Walmart’s part, the company clarified in a statement to Fast Company that, when shopping for apparel, the price posted at the top of the rack is the highest price of any item on the rack, and that this system is nothing new for the company. Per a press release, Walmart is offering 14 of the most common school supplies for lower prices this year than last year. Tariff fears compound general financial anxiety Parents are feeling the back-to-school sticker shock this year, as concerns around potential impending tariff hikes are also compounded by a more general sense of financial stress. Based on the June Consumer Price Index reporta metric that measures overall cost of living in the U.S.inflation rose by 0.3% across the board in June, the highest monthly reading since January. Another July study from Credit Karma found that 39% of surveyed parents reported that they were unable to afford back-to-school shopping this year (up from 31% in 2024), with 44% planning to take on debt as a result. I feel as if [prices] keep going up, $125 is insane on just supplies, one TikTok user captioned her Walmart back-to-school haul. Tell me why colored pencils are now 97 cents and no longer a quarter? another user added in a storytime on her shopping experience this year. I felt like I was about to pass outnot from the heat, but from these prices.
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E-Commerce
A federal judge is set to hear closing arguments Wednesday over whether to stop construction indefinitely at an immigrant detention center in the Florida Everglades dubbed “Alligator Alcatraz” as she considers whether it violates environmental laws.U.S. District Judge Kathleen Williams ordered a two-week halt on new construction last Thursday as witnesses continued to testify in a hearing to determine whether construction should end until the ultimate resolution of the case.The temporary order doesn’t include any restrictions on law enforcement or immigration enforcement activity at the center, which is currently holding hundreds of detainees. The center, which was quickly built two months ago at a lightly used, single-runway training airport, is designed to eventually hold up to 3,000 detainees in temporary tent structures.The order temporarily barred the installation of any new industrial-style lighting, as well as any paving, filling, excavating, fencing or erecting additional buildings, tents, dormitories or other residential or administrative facilities.Environmental groups and the Miccosukee Tribe want Williams to issue a preliminary injunction to halt operations and further construction, which they say threatens environmentally sensitive wetlands that are home to protected plants and animals and would reverse billions of dollars’ worth of environmental restoration.Plaintiffs presented witnesses Wednesday and Thursday who testified that the facility violates the National Environmental Policy Act, which requires federal agencies to assess the environmental effects of major construction projects.Attorneys for the state and federal government have said that although the detention center would be holding federal detainees, the construction and operation of the facility is entirely under the state of Florida, meaning the federal environmental review wouldn’t apply.The judge last week said the detention facility was, at a minimum, a joint partnership between the state and federal government. Witnesses describe environmental threats Witnesses for the environmental groups have testified that at least 20 acres (8 hectares) of asphalt have been added to the site since the Florida Division of Emergency Management began construction. They said additional paving could lead to an increase in water runoff to the adjacent wetlands, spread harmful chemicals into the Everglades and reduce the habitat for endangered Florida panthers.Amy Castaneda, the Miccosukee Tribe’s water resource director, testified Tuesday that nutrient runoff from the detention center could flow into tribal lands, changing vegetation growth. That could lead to fish kills and block humans and wildlife from moving throughout certain areas, she said.Marcel Bozas, director of the Miccosukee Tribe’s fish and wildlife department, said tribe members hunt and fish for subsistence and cultural reasons. Sustained human activity can drive away game animals, like whitetail deer, as well as protected species, like Florida panthers, wood storks, eastern black rails and bonneted bats, he said. State official says Florida runs center Department of Highway Safety and Motor Vehicles executive director David Kerner testified that the 1,800 state troopers under his command are authorized to detain undocumented migrants under an agreement with the U.S. Department of Homeland Security. He said the federal government doesn’t tell the state where to detain immigrants, and that the Everglades facility was built to alleviate overcrowding at federal immigration detention facilities, as well as state and county facilities with agreements to hold federal immigration detainees.Kerner couldn’t say how many of the “Alligator Alcatraz” detainees have been charged with violent crimes or whether any other sites besides the middle of the Everglades were considered for possible detention centers.Attorneys for federal and state agencies last month asked Williams to dismiss or transfer the injunction request, saying the lawsuit was filed in the wrong jurisdiction. Even though the property is owned by Miami-Dade County, Florida’s southern district is the wrong venue for the lawsuit because the detention center is in neighboring Collier County, which is in the state’s middle district, they said.Williams had yet to rule on that argument. Facility faces a second legal challenge In a second legal challenge to “Alligator Alcatraz,” a federal judge over the weekend gave the state more time to prepare arguments against an effort to get the civil rights litigation certified as a class action.U.S. District Judge Rodolfo Ruiz in Miami said he will only consider a motion by detainees’ lawyers for a preliminary injunction during an Aug. 18 hearing. He set a Sept. 23 deadline for the state to respond to the detainee’s class action request. The second lawsuit claims detainees’ constitutional rights are being violated because they are barred from meeting lawyers, are being held without any charges, and a federal immigration court has canceled bond hearings.The lawsuits were being heard as DeSantis’ administration apparently was preparing to build a second immigration detention center at a Florida National Guard training center in north Florida. At least one contract has been awarded for what is labeled in state records as the “North Detention Facility.” David Fischer, Associated Press
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E-Commerce
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