Module A: the data and coding layer

Exploration notebook, module A: existing outputs only, no new analysis

Back to the report · Project site · Interactive budget model

A tested warehouse (54 dbt models, 10 seeds, 126 tests) sits behind every number. This notebook looks at what the data layer shows before any model: reporting completeness, spending, the timeline of events and the pipeline.

From NDC to label group

289 NDC codes resolve to 17 products and 8 ingredients; 102 carry an obesity label and 187 a diabetes label (counts of NDC codes, not prescriptions).

label_group ingredient product ndc_codes
Diabetes label Albiglutide Tanzeum 5
Diabetes label Dulaglutide Trulicity 23
Diabetes label Exenatide Byetta 19
Diabetes label Exenatide Bydureon 7
Diabetes label Exenatide Generic exenatide 2
Diabetes label Liraglutide Generic liraglutide 27
Diabetes label Liraglutide Victoza 9
Diabetes label Liraglutide Xultophy 3
Diabetes label Lixisenatide Soliqua 4
Diabetes label Lixisenatide Adlyxin 2
Diabetes label Semaglutide Ozempic 21
Diabetes label Semaglutide Rybelsus 16
Diabetes label Tirzepatide Mounjaro 49
Obesity label Liraglutide Generic liraglutide 11
Obesity label Liraglutide Saxenda 5
Obesity label Orforglipron Foundayo 13
Obesity label Semaglutide Wegovy 22
Obesity label Tirzepatide Zepbound 51

Flow diagram from 289 NDC codes to 17 products, 8 ingredients and two label groups. 102 NDC codes carry an obesity label (Wegovy, Zepbound, Saxenda, Foundayo and generic liraglutide for weight management) and 187 a diabetes label.

NDC to product to ingredient to label group

Reporting completeness and suppression

81.0% of state-quarters have both fee-for-service and managed-care rows and 40.3% of Wegovy and Zepbound rows are suppressed (counts under 11).

status n share
Both FFSU and MCOU rows 1363 0.8098633
FFSU rows only 320 0.1901367
item value
state_quarters 1683.0
state_quarters_no_rows 0.0
share_no_rows_pct 0.0
wz_rows 6695.0
wz_rows_suppressed 2699.0
wz_suppressed_share_pct 40.3

Two heatmaps of state by quarter, 2018 to 2026. Top: whether a state-quarter has SDUD rows for fee-for-service and managed-care utilization; most tiles show both, and the others have fee-for-service rows only (no managed-care rows). Bottom: the suppressed share of Wegovy and Zepbound rows, which varies by state and quarter; overall 40.3 percent of rows are suppressed.

SDUD reporting and suppression by state and quarter

Spending by brand

Gross of rebates: Part D 7.0 to 27.5 billion dollars (2020 to 2024); Medicaid 1.5 to 8.8 billion.

program year spend_billions
Medicaid 2020 1.51
Medicaid 2021 2.52
Medicaid 2022 4.18
Medicaid 2023 7.08
Medicaid 2024 8.77
Medicare Part D 2020 7.02
Medicare Part D 2021 9.95
Medicare Part D 2022 13.91
Medicare Part D 2023 22.21
Medicare Part D 2024 27.51

Two line charts of gross spending by brand, 2020 to 2024, with direct labels. Medicare Part D total rises from 7.0 to 27.5 billion dollars and Medicaid from 1.5 to 8.8 billion; Ozempic is the largest brand in both programs in 2024 and Mounjaro grows fastest. Obesity-labeled brands (Wegovy, Zepbound, Saxenda) are small in Part D and larger in Medicaid.

Gross spending by brand

Timeline and pipeline

Registered studies of the in-scope ingredients: 634 list obesity, 59 are ongoing Phase 3.

phase_group studies ongoing
Phase 1 (including early Phase 1) 80 28
Phase 2 (including Phase 1/2) 105 53
Phase 3 (including Phase 2/3) 147 59
Phase 4 133 58
Not applicable / not stated 169 99
item value
registered_studies_in_scope 1569
obesity_studies 634
obesity_studies_ongoing 297
obesity_phase3_ongoing 59
oral_obesity_studies 46
oral_obesity_phase3_ongoing 9
orforglipron_obesity_studies 23
orforglipron_phase3_obesity_studies 14

Three stacked timelines from 2021 to 2027. Top: FDA approvals and indications: Wegovy approved in June 2021 with a cardiovascular indication in March 2024, Zepbound approved in November 2023 with a sleep apnea indication in December 2024, Wegovy tablets approved in December 2025 and Foundayo approved in April 2026. Middle: the number of primary-analysis states with active Medicaid coverage rises from one to about ten in 2025 and falls from late 2025 as coverage ends in several states. Bottom: the announced $245 price in November 2025 and the Medicare GLP-1 Bridge from July 2026 to December 2027.

Timeline of approvals, coverage and federal events

Coverage criteria completeness

Prior authorization is documented for 16 of 17 states, BMI thresholds for 12, comorbidity rules for 13 and step therapy for 13.

field documented not_found states
Prior authorization 16 1 17
BMI threshold 12 5 17
Comorbidity requirement 13 4 17
Step therapy 13 4 17

Tile-grid map of the United States showing Wegovy and Zepbound prescriptions per 1,000 Medicaid enrollees in 2025 Q3 for each state, darker orange for higher rates. States with active Medicaid coverage have a dark outline and average 37.0 per 1,000, against 0.7 in other states.

Prescriptions per 1,000 Medicaid enrollees, 2025 Q3

Part of the project report; every number comes from analysis/outputs/key_numbers.csv. Public aggregate data; no company affiliation or endorsement.