Zepbound leads Wegovy with nearly 339,000 weekly US prescriptions

Zepbound (tirzepatide) recorded close to 339,000 US prescriptions in the week that ended April 18, 2025, outpacing Wegovy (semaglutide) by about 127,000 fills, according to IQVIA data reported by Reuters ^[1]. Those figures count all weekly prescriptions rather than only new starts, so the lead reflects total volume as well as newly treated patients ^[1].

That milestone arrived during a rough stretch for Eli Lilly, which sells Zepbound. CVS Health, one of the country's largest pharmacy benefit managers, said it would stop covering Zepbound for obesity, while keeping Wegovy on its lists after negotiating a lower price with Novo Nordisk ^[1]. Lilly's stock closed almost 12% lower after that disclosure and the company's earnings update ^[1].

Lilly also told investors it would not raise its full-year revenue guidance and trimmed its profit projection slightly, even as first-quarter revenue climbed 45% on the strength of Zepbound and Mounjaro (tirzepatide), its diabetes medicine ^[1]. Zepbound sales reached $2.31 billion in the first three months of 2025, four times the same quarter a year earlier, and Mounjaro sales more than doubled to $3.84 billion ^[1]. Novo Nordisk's first-quarter results were scheduled for release on May 7 ^[1].

On the company's earnings call, Lilly chief executive David Ricks said the CVS decision did not catch him off guard because Zepbound is "gaining a lot of market share," and he rejected the idea of exclusive deals that narrow patient options: "We're not interested at all in one of one deals [...] reducing access and choice for doctors and patients" ^[1]. He added that the employers most likely to feel the change are smaller ones that generally do not cover obesity care anyway. "We'll work through it," Ricks said. "Our job will be to continue to drive share and preference for our brand" ^[1].

Separately, Novo Nordisk has formed partnerships with three telehealth companies to promote self-pay purchases of Wegovy ^[1]. In a head-to-head clinical trial, Zepbound proved more effective than Wegovy at helping people lose weight ^[1].

Ricks also pointed to orforglipron, Lilly's once-daily oral candidate that would follow Zepbound. He said the company expects results from three of seven phase 3 trials and its first regulatory submissions before the year ends, and that he is "excited by the possibility of an oral that could be more widely distributed around the world" ^[1].

Why it matters for patients

Getting a GLP-1 often depends on what an insurer or pharmacy benefit manager agrees to cover, not only on what a clinician prescribes. By keeping Wegovy but removing Zepbound for obesity, CVS Health split the two leading brands for people enrolled in plans it manages ^[1]. How many patients or employer plans are affected has not been reported, and Ricks suggested the fallout would land mostly on smaller employers that typically exclude obesity treatment ^[1].

Nor is it known how much lower the Wegovy price CVS negotiated is, when any coverage change would take effect, or whether patients already taking Zepbound through an affected plan could stay on it ^[1]. Self-pay is one route the manufacturers are promoting, with Novo Nordisk's telehealth arrangements aimed at cash-paying customers, but the amounts those patients would pay are not disclosed ^[1].

It also helps to separate two different measures. Prescription counts show what is being prescribed and filled; coverage decisions show who pays for it. Zepbound can lead in weekly fills, as it did here, while at the same time losing a major payer's business ^[1].

What happens next

• Novo Nordisk was scheduled to report first-quarter figures on May 7, 2025 ^[1].
• Lilly expects phase 3 data from three of seven orforglipron trials and its first regulatory filings by the end of 2025 ^[1].
• No start date for CVS Health's Zepbound coverage change, and no estimate of how many patients it affects, has been reported ^[1].