The 2026 GLP-1 Affordability Index
GLP-1s Work. But the Math Does Not.
For the first time, science has produced a reliable treatment for the obesity epidemic. But when you translate the cost from dollars into hours of human labor, a structural trap emerges. A 28-day prescription contains exactly 160 full-time working hours. At minimum wage in 20 states, the drug requires more hours than the month contains. This index measures the true labor cost — state by state, in working days.
This Is Not a Coincidence
Plot each state's CDC obesity rate against its GLP-1 labor cost, and the pattern is undeniable. The states in the top-right quadrant — high obesity, high cost — are trapped in what we call the “Double Bind.” Mississippi, West Virginia, Arkansas, Oklahoma, Kentucky: the populations most likely to benefit from GLP-1 treatment are structurally the least able to afford it.
22 states fall in the “Double Bind” quadrant — above-median obesity AND above-median labor hours to afford GLP-1s. Mississippi (40.4% obesity, 36.8h) and West Virginia (41.4%, 33.9h) face a systemic paradox. Tennessee excluded: CDC reports insufficient data for 2024.
A 28-day prescription contains exactly 160 full-time working hours. At $7.25/hr, one month of Wegovy requires 186 hours — 116% of a full-time month. That isn't a budgeting problem. It's an arithmetic impossibility. No amount of meal-prepping or coupon-clipping fixes a month that doesn't have enough hours.
Novo Nordisk says the list price drops to $675/month starting Jan 1, 2027. But $675 at $7.25/hr is still 93 hours — 58% of a full-time month. In Mississippi at minimum wage, that's still 12 working days. The trap loosens. It does not open.
Where Do You Fall?
Enter your hourly wage. See how many working days go entirely to one prescription.
Same drug. Same price. Three different realities.
The National Map
The redder the state, the more working days surrendered. Toggle to Minimum Wage + Wegovy at List Price and watch 20 states go black — not because it's expensive, but because the math stops working. A full month of labor isn't enough to cover a single prescription.
Showing: Ozempic at list price (WAC) · Wage: average hourly earnings
Complete Rankings
#1 = heaviest labor burden. Click any column to sort. Click a state name to view its full profile.
| # | State | Working Days | Hours |
|---|---|---|---|
| 1 | MississippiDB | 5 | 36.8h |
| 2 | ArkansasDB | 5 | 34.5h |
| 3 | New MexicoDB | 5 | 34.2h |
| 4 | West VirginiaDB | 5 | 33.9h |
| 5 | LouisianaDB | 5 | 33.8h |
| 6 | KentuckyDB | 5 | 33.6h |
| 7 | IowaDB | 5 | 33.4h |
| 8 | OklahomaDB | 5 | 33.0h |
| 9 | Tennessee | 5 | 32.5h |
| 10 | South DakotaDB | 5 | 32.2h |
| 11 | AlabamaDB | 5 | 32.1h |
| 12 | NevadaDB | 4 | 31.5h |
| 13 | KansasDB | 4 | 31.5h |
| 14 | MissouriDB | 4 | 31.4h |
| 15 | IndianaDB | 4 | 31.3h |
| 16 | Wyoming | 4 | 31.3h |
| 17 | Montana | 4 | 31.0h |
| 18 | NebraskaDB | 4 | 30.9h |
| 19 | OhioDB | 4 | 30.9h |
| 20 | South CarolinaDB | 4 | 30.8h |
| 21 | Maine | 4 | 30.8h |
| 22 | PennsylvaniaDB | 4 | 30.8h |
| 23 | MichiganDB | 4 | 30.4h |
| 24 | DelawareDB | 4 | 30.4h |
| 25 | North CarolinaDB | 4 | 29.7h |
| 26 | WisconsinDB | 4 | 29.7h |
| 27 | Arizona | 4 | 29.3h |
| 28 | Idaho | 4 | 29.2h |
| 29 | Florida | 4 | 29.2h |
| 30 | Texas | 4 | 28.9h |
| 31 | New Hampshire | 4 | 28.8h |
| 32 | Utah | 4 | 28.8h |
| 33 | Vermont | 4 | 28.7h |
| 34 | North Dakota | 4 | 28.6h |
| 35 | Illinois | 4 | 28.5h |
| 36 | Georgia | 4 | 28.3h |
| 37 | Maryland | 4 | 28.0h |
| 38 | Virginia | 4 | 27.4h |
| 39 | Rhode Island | 4 | 27.1h |
| 40 | Oregon | 4 | 26.7h |
| 41 | Hawaii | 4 | 26.6h |
| 42 | Alaska | 4 | 26.4h |
| 43 | New Jersey | 4 | 26.2h |
| 44 | New York | 4 | 25.9h |
| 45 | Connecticut | 4 | 25.7h |
| 46 | Minnesota | 4 | 25.7h |
| 47 | Colorado | 4 | 25.3h |
| 48 | California | 4 | 24.4h |
| 49 | Massachusetts | 3 | 24.0h |
| 50 | Washington | 3 | 23.6h |
| 51 | D.C. | 3 | 18.0h |
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Citation
When referencing this data:
In 20 states, a full-time minimum-wage job can’t buy a single month of America’s most prescribed weight loss drug.
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According to the 2026 GLP-1 Affordability Index, American workers earning median wages must spend an average of 11.9% of their monthly take-home pay on GLP-1 weight loss medication — with a 16-state "Double Bind" concentrating the crisis where obesity rates are highest and affordability is lowest.
The 2026 GLP-1 Affordability Index finds that in 20 U.S. states, minimum-wage workers face a "160-Hour Wall" — the list price of Wegovy requires more labor hours than exist in a full-time work month, making the medication mathematically unaffordable through wages alone.
The Double Bind
16 U.S. states rank in the top 20 for adult obesity while also ranking in the bottom half for GLP-1 affordability — meaning the Americans who need weight loss medication most are the least able to afford it. Of these, only 5 have Medicaid programs that cover GLP-1 medications for obesity.
Read the full Double Bind analysis →Press & Media
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51 individual state profiles with full data, citations, and downloadable stat cards.
Source: GLP-1 Affordability Index, Weight Loss Provider Guide, 2026. Licensed under CC BY 4.0.