Prices for the two leading obesity injections—Novo Nordisk’s semaglutide shot Wegovy and Eli Lilly’s tirzepatide shot Zepbound—have slipped to roughly $500 a month for people without insurance, several hundred dollars below their initial launch levels. Yet steady access remains elusive. Employers wary of rising drug bills have been slow to add the medicines to benefit plans, and most Medicaid programs and Medicare still refuse to cover them for weight-loss alone. Coverage that is available can vanish quickly. CVS Health’s Caremark pharmacy-benefit manager removed Zepbound from its national formulary on 1 July in favor of Wegovy, forcing physicians to rewrite prescriptions for patients who had tolerated Lilly’s drug better. Novo Nordisk says 200,000 Wegovy prescriptions are filled each week in the United States and that 85 % of insured patients pay no more than $25 a month, but those without coverage are still exposed to the full retail price. Compounded, lower-priced copies that proliferated during last year’s shortage are being squeezed out. The US Food and Drug Administration has declared the shortage over, and Lilly has sued several compounders, while Novo Nordisk ended a brief partnership with telehealth provider Hims after the company continued offering bespoke semaglutide doses. As demand builds—Zepbound generated $2.3 billion in US sales last quarter and Wegovy $1.9 billion—researchers are probing risks tied to the drug class. A study shared this week found that 76.2 % of patients on GLP-1 receptor agonists tested positive for small-intestinal bacterial overgrowth, and University of Toronto scientists are investigating links between semaglutide use and certain eye disorders. Some obesity specialists argue the injections should move earlier in treatment algorithms for people at high cardiovascular or metabolic risk, while others caution that long-term success will depend on sustained lifestyle interventions once patients stop therapy. Pill versions expected next year could lower prices further and expand the market, but for now cost and coverage remain the main barriers to wider adoption.