Eli Lilly and Company announced results from a real-world study of adults over 55 with obesity or overweight showing that staying on Zepbound (tirzepatide) for weight management lowered healthcare costs over time relative to similar untreated adults.

The study highlighted that the lower costs were driven in part by fewer hospital admissions and emergency department visits. For adults over the age of 55, including patients in Medicare's GLP-1 Bridge program, the lower costs translated into meaningful savings as early as 12 months into treatment.¹

The study is the first of its kind in this age group, and arrive as coverage for GLP-1 obesity medications continues to expand across Medicare, state programs, and employer plans, giving payers and policymakers new real-world evidence on the cost implications of long-term obesity treatment in an older population.

What did the study find?

Researchers estimated cost differences over time, excluding the cost of Zepbound itself, using two established analytic methods, both of which showed on average lower monthly healthcare costs with sustained Zepbound use compared with adults who were untreated.² At six months, costs were up to 15% lower, a difference of up to $181 per patient, per month. That gap widened by 12 months, with an estimated difference of up to $607 per patient, per month, reflecting on average up to 38% lower costs than those not treated.²

In the primary analysis, adults older than 55 treated with Zepbound had lower rates of hospital admissions and emergency department visits across every follow-up period, alongside numerically higher rates of routine outpatient and office visits, a pattern consistent with greater engagement in routine care rather than acute crisis care.²

The cost picture was particularly notable for patients in the Medicare GLP-1 Bridge program. Beginning at six months, estimated healthcare cost savings nearly covered the program's monthly treatment cost of $195 per patient, per month, while starting at 12 months, estimated healthcare cost savings exceeded the cost of Zepbound treatment altogether, suggesting that sustained treatment in an aging population may lead to meaningful cost savings over time.²

In a recent conversation with Pharmaceutical Executive, Susan Thomas, chief commercial officer at LucyRx, spoke about the importance of GLP-1 coverage. "Plan sponsors often focus on the immediate cost implication rather than the long-term return — and that's why GLP-1 coverage has become a budget line item rather than a strategy for serving a population over the long haul."

How was the study conducted?

The retrospective observational cohort study drew on Komodo's Healthcare Map, which includes de-identified claims data from more than 330 million individuals enrolled in U.S. healthcare plans.² The analysis included 15,843 adults older than 55, with a mean age of 64.5 years, who had obesity (BMI of 30 kg/m² or higher) or overweight (BMI of 27 kg/m² or higher) with at least one obesity-related complication, and who initiated Zepbound between November 2023 and September 2025.¹ Each Zepbound user was matched one-to-one with a control who met the same eligibility criteria but did not initiate any GLP-1 or GIP/GLP-1 receptor agonist medication, with matching based on baseline demographics, clinical characteristics, obesity-related complications and healthcare utilization patterns.² All participants had at least 12 months of continuous enrollment prior to the start of the study.

Because not all patients remained in the study for the same length of time, researchers used two complementary analytic methods to account for that variation. First, a pairwise analysis that directly compared costs between matched pairs, designated the secondary analysis, and an Inverse Probability of Censoring Weighting analysis that statistically reweighted results so that patients who left the study early were still fairly represented, designated the primary analysis.¹

At six months, the pairwise analysis showed a 15% lower increase in costs, a difference of $181 per patient, per month, while the Inverse Probability of Censoring Weighting analysis showed a 12% lower increase, a difference of $145 per patient, per month.¹ At 12 months, the pairwise analysis showed an estimated difference of $607 per patient, per month, reflecting on average 38% lower costs, while the Inverse Probability of Censoring Weighting analysis showed an estimated difference of $319 per patient, per month, reflecting on average 25% lower costs. Both approaches showed consistent results.

Because claims data do not capture Zepbound's net price, the study excluded the cost of Zepbound from total treatment costs. As a result, the reported cost differences reflect potential savings that could offset the price of Zepbound rather than the net cost impact of treatment overall.¹

Why does this matter?

"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 U.S. 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."

Sources

1. Zepbound linked to lower healthcare costs in adults over age 55 with obesity according to a real-world study Eli Lilly And Company August 26, 2026, https://investor.lilly.com/news-releases/news-release-details/zepbound-linked-lower-healthcare-costs-adults-over-age-55
2. Trends in Cost of Care With Tirzepatide in Adults Aged Over 55 Years With Obesity or Overweight Without Diabetes: A Matched Cohort Analysis Diabetes Obesity and Metabolism August 24, 2026, https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.71250