Older adults taking Eli Lilly’s Zepbound for weight management incurred substantially lower healthcare costs than similar untreated patients, according to a new real-world study that found the gap widened significantly after a year of treatment.
The study, published in Diabetes, Obesity and Metabolism, examined 15,843 adults over age 55 with overweight or obesity who began taking Zepbound (tirzepatide).
Researchers found that sustained use was associated with fewer hospital admissions and emergency department visits and lower monthly healthcare costs, excluding the cost of Zepbound itself.
The findings could carry particular weight as Medicare expands access to GLP-1 treatments for obesity.
At six months, monthly healthcare costs were as much as 15% lower, or up to $181 less per patient, among people taking Zepbound compared with matched untreated adults.
By 12 months, the difference had widened to as much as $607 per patient per month, representing an average reduction of 38% in healthcare costs under one analysis.
"This compelling real-world evidence highlights the impact that treating obesity with Zepbound can have on older patients and the healthcare system," said Ilya Yuffa, executive vice president and president, Lilly USA and Global Customer Capabilities.
"This analysis shows treatment costs can be lowered, and in some cases more than covered, by savings elsewhere in care – including for payers and in Medicare. As coverage expands across Medicare, states and employers, these data offer evidence on the cost implications of long-term obesity treatment and should help shape decisions."
The study found that adults older than 55 treated with Zepbound had lower rates of hospital admissions and emergency department visits across every follow-up period in the primary analysis.
At the same time, patients taking Zepbound had numerically higher rates of routine outpatient and office visits, which the researchers said was consistent with greater engagement in routine care.
The cost differences emerged relatively quickly. Beginning at six months, estimated healthcare savings nearly covered the $195 monthly treatment cost under Medicare’s GLP-1 Bridge program.
At 12 months, estimated savings exceeded that monthly treatment cost, suggesting that sustained obesity treatment could potentially generate meaningful healthcare savings in an aging population.
Researchers used Komodo Health’s Healthcare Map, which contains de-identified claims data from more than 330 million people enrolled in U.S. healthcare plans.
The analysis included adults aged over 55 with obesity, defined as a BMI of at least 30, or overweight, defined as a BMI of at least 27, combined with at least one obesity-related complication. Participants began Zepbound between November 2023 and September 2025.
Each Zepbound user was matched with an untreated control who met the same eligibility criteria but had not started a GLP-1 or GIP/GLP-1 receptor agonist. Researchers matched patients on demographics, clinical characteristics, obesity-related complications and healthcare utilization patterns.
All participants had at least 12 months of continuous enrollment before entering the study.
Researchers used two statistical approaches to account for differences in how long patients remained in the study. Both produced consistent results showing lower monthly healthcare costs among patients who sustained Zepbound treatment.
At six months, the pairwise analysis found a 15% lower increase in costs, equivalent to $181 per patient per month. The primary Inverse Probability of Censoring Weighting analysis found a 12% lower increase, or $145 per patient per month.
At 12 months, the pairwise analysis estimated a difference of $607 per patient per month, or 38% lower costs. The primary analysis estimated a difference of $319 per patient per month, or 25% lower costs.
The findings do not represent the overall net cost of Zepbound treatment.
Because claims data do not capture Zepbound’s net price, researchers excluded the drug’s cost from the analysis. The reported differences therefore represent potential savings in other healthcare spending that could offset the cost of treatment, rather than proof that Zepbound itself reduces total healthcare spending after accounting for its price.
Still, the study offers new real-world evidence on the potential economic impact of treating obesity in older adults — a population facing rising healthcare needs and increasingly broad access to GLP-1 medications.
