Blockbuster GLP-1 medications like Ozempic and Wegovy are transforming patient care, altering surgery volumes and redefining the healthcare industry's financial landscape.
The obesity drug market could reach $200 billion by 2031, according to industry projections. Perhaps unsurprisingly, some health systems and industry disruptors are expanding weight loss programs in response to the growing demand for GLP-1s.
Beyond weight loss programs, GLP-1 medications are influencing multiple hospital and ambulatory surgery center service lines. In healthcare C-suites, this trend is influencing long-term operational and financial decisions, especially as GLP-1 medicines affect elective surgery volumes.
Elective surgeries are a substantial revenue source for hospitals and ASCs, and several procedures could rapidly decline in volume over the next few years.
As a result of widespread GLP-1 uptake, about 60% of profits across eight high-margin therapeutic areas might be at risk by 2029, according to global management consulting firm Kearney.
For example, artery bypass grafting volumes are anticipated to decline by 17%, peripheral revascularization by 16% and carotid artery stenting by 11%. These declines contribute to a projected $7.5 billion loss in revenue over the next four years due to GLP-1 demand, Kearney said.
Here's a closer look into how GLP-1s affect several key service lines:
Bariatrics
As more patients seek GLP-1 medications, bariatric surgery volumes are falling. The American Society for Metabolic and Bariatric Surgery estimated a slight increase in bariatric operations, from 262,000 to 280,000, between 2021 and 2022. Near the end of 2022, however, the trend flipped as GLP-1 usage began rising for weight loss use.
Throughout 2023 and early 2024, bariatric surgeons told Becker's they were seeing a 10% to 20% decrease in weight loss surgeries. Research has since backed up the anecdotal evidence; a study found that, between 2022 and 2023, GLP-1 drug prescriptions increased 132.6% while bariatric surgery rates fell 25.6%.
Citing a 30% drop in weight loss surgery volumes amid higher GLP-1 usage, Norman (Okla.) Regional Health System closed its bariatric program and a weight loss clinic in 2024. More health systems may scale back or close bariatric programs as GLP-1 adoption grows.
By 2034, inpatient bariatric surgery rates are expected to decline another 15%, according to Vizient. Kearney predicts this 15% drop to happen by 2029.
Transplant medicine
Unlike bariatrics, some transplant programs have seen a slight increase in volumes due to GLP-1 medications. Patients with high body mass indexes often face strict cutoffs for transplants because of an increased risk of complications. However, with the strong efficacy of GLP-1s, health systems have created stronger ties between their endocrine and weight loss service lines.
For example, at Houston Methodist, two leaders crafted a formal pipeline between the kidney transplant team and the endocrinology team to help patients lose weight and become eligible for transplants.
Spine and orthopedic care
Similar to transplants, many orthopedic surgeons will not operate on patients who have a body mass index higher than 40. While GLP-1s may help more patients qualify for surgery, fewer obesity-related conditions could reduce demand for knee replacements, hip replacements, and spinal fusions.
John Prunskis, MD, CEO and medical director of Elgin-based Illinois Pain & Spine Institute, told Becker's his predictions for how GLP-1s will affect his industry.
"Initially, the effect of these drugs will have little impact on spine and orthopedics. However, in a few years' time, it will have a bearish effect as thinner people will have fewer spine and orthopedic problems," Dr. Prunskis said. "After a few more years, business will pick up again since people will be living longer."
Kearney predicts a 20% decline in coronary angioplasty procedures by 2029. The firm also expects knee replacement surgery volumes to decrease by 16%, hip replacement by 10% and spine fusion by 8%.
Cardiology
With artery bypass grafting volumes projected to decline 17%, GLP-1s could significantly affect cardiovascular care.
Four GLP-1 medications — Ozempic, Trulicity, Victoza and Wegovy — are approved to reduce the risk of major adverse cardiovascular events in adults with cardiovascular disease. In one study, Ozempic and Wegovy reduced annual healthcare costs by $9,276 for patients with heart failure or atherosclerotic cardiovascular disease.
What remains unclear is how hospitals and ASCs will adapt to shifting patient needs, reimbursement changes, and the evolving role of GLP-1s in chronic disease management.