How many hours of work does it take to afford GLP-1 medication in the U.S.?

On average, American workers earning median wages must work approximately 15.5 hours to afford one month of GLP-1 medication at the best self-pay price ($349/month). At list price ($1,349/month for Wegovy), the burden is far greater.

What is the '160-Hour Wall' for GLP-1 medications?

In 20 U.S. states, minimum-wage workers would need to work more than 160 hours — the total hours in a standard full-time work month — just to afford one month of Wegovy at list price. This makes the medication mathematically unaffordable through wages alone in those states.

What are 'Double Bind' states in the GLP-1 Affordability Index?

The GLP-1 Affordability Index identifies 16 "Double Bind" states — states that rank in the top 20 for adult obesity prevalence while also ranking in the bottom half for GLP-1 medication affordability. These are the states where people who most need weight loss medication are least able to afford it.

Does Medicaid cover GLP-1 medications for obesity?

Only 14 state Medicaid programs cover GLP-1 medications for obesity treatment as of January 2026. Workers in the remaining 37 states must pay entirely out of pocket if their private insurance denies coverage.

Which state is the least affordable for GLP-1 medication?

Mississippi ranks #1 (least affordable) in the 2026 GLP-1 Affordability Index, with workers earning median wages needing to spend 15.0% of their monthly take-home pay — equivalent to 19.6 hours of work — to afford one month of GLP-1 medication at self-pay pricing.

Wages: Dec 2025 (BLS) · Prices: Feb 2026 (Novo Nordisk) · Obesity: 2024 (CDC)

The 2026 GLP-1 Affordability Index

Data version notice: The interactive display and the linked historical CSV currently use different input versions. The historical export uses fixed $349 self-pay and $1,349 Wegovy list-price assumptions; it does not reproduce every scenario shown in the interactive display. Use each version only with its stated price, wage, coverage and observation dates. Current coverage and current treatment quotes must be checked separately. Do not combine figures from these versions or treat their classifications as directly comparable. A current unified comparison requires one documented version across the tool, export and state profiles.

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.

#1 Least Affordable

Mississippi

$27.91/hr · 40.4% obesity

5working days

36.8 hours · 23% of monthly income

#51 Most Affordable

D.C.

$57.10/hr · 25.5% obesity

3working days

18.0 hours · 11% of monthly income

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.

The interactive display defines its “Double Bind” quadrant using above-median obesity and above-median labor hours under its selected assumptions. The historical export and profiles use a different definition: top-20 obesity and bottom-half affordability. Because the definitions and input versions differ, their counts and classifications should not be combined. Tennessee is excluded from the obesity comparison where the underlying CDC series reports insufficient data.

Read the full Double Bind analysis →

The 160-Hour Wall

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.

The 2027 Question

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.

$/hr

Same drug. Same price. Three different realities.

$7.25/hr

Federal Minimum Wage

18 days

141.7 hours of labor

89% of a full-time month

$17.00/hr

Working Class (~$35k/yr)

8 days

60.4 hours of labor

38% of a full-time month

$55.00/hr

Professional (~$115k/yr)

3 days

18.7 hours of labor

12% of a full-time month

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

3 days

5+ days

Complete Rankings

#1 = heaviest labor burden. Click any column to sort. Click a state name to view its full profile.

#	State	Working Days	Hours	% of 160h	Obesity
1	MississippiDB	5	36.8h	23.0%	40.4%
2	ArkansasDB	5	34.5h	21.6%	38.9%
3	New MexicoDB	5	34.2h	21.4%	34.5%
4	West VirginiaDB	5	33.9h	21.2%	41.4%
5	LouisianaDB	5	33.8h	21.2%	39.2%
6	KentuckyDB	5	33.6h	21.0%	37.2%
7	IowaDB	5	33.4h	20.9%	36.6%
8	OklahomaDB	5	33.0h	20.6%	36.8%
9	Tennessee	5	32.5h	20.3%	N/A
10	South DakotaDB	5	32.2h	20.1%	37%
11	AlabamaDB	5	32.1h	20.1%	38.9%
12	NevadaDB	4	31.5h	19.7%	34.2%
13	KansasDB	4	31.5h	19.7%	37.6%
14	MissouriDB	4	31.4h	19.6%	34.6%
15	IndianaDB	4	31.3h	19.5%	38.4%
16	Wyoming	4	31.3h	19.5%	32.5%
17	Montana	4	31.0h	19.4%	31%
18	NebraskaDB	4	30.9h	19.3%	37.6%
19	OhioDB	4	30.9h	19.3%	36.9%
20	South CarolinaDB	4	30.8h	19.3%	34.6%
21	Maine	4	30.8h	19.3%	33.2%
22	PennsylvaniaDB	4	30.8h	19.2%	34.2%
23	MichiganDB	4	30.4h	19.0%	36.1%
24	DelawareDB	4	30.4h	19.0%	36.6%
25	North CarolinaDB	4	29.7h	18.6%	34.5%
26	WisconsinDB	4	29.7h	18.6%	37.4%
27	Arizona	4	29.3h	18.3%	33.3%
28	Idaho	4	29.2h	18.3%	32.7%
29	Florida	4	29.2h	18.3%	29.6%
30	Texas	4	28.9h	18.1%	35.6%
31	New Hampshire	4	28.8h	18.0%	31.1%
32	Utah	4	28.8h	18.0%	31%
33	Vermont	4	28.7h	18.0%	29%
34	North Dakota	4	28.6h	17.9%	36.8%
35	Illinois	4	28.5h	17.8%	34.2%
36	Georgia	4	28.3h	17.7%	35.4%
37	Maryland	4	28.0h	17.5%	32.7%
38	Virginia	4	27.4h	17.1%	32.3%
39	Rhode Island	4	27.1h	16.9%	31.1%
40	Oregon	4	26.7h	16.7%	33.5%
41	Hawaii	4	26.6h	16.7%	27%
42	Alaska	4	26.4h	16.5%	34%
43	New Jersey	4	26.2h	16.4%	27.7%
44	New York	4	25.9h	16.2%	29.5%
45	Connecticut	4	25.7h	16.1%	32%
46	Minnesota	4	25.7h	16.0%	32.3%
47	Colorado	4	25.3h	15.8%	25%
48	California	4	24.4h	15.3%	29.1%
49	Massachusetts	3	24.0h	15.0%	27%
50	Washington	3	23.6h	14.8%	31.5%
51	D.C.	3	18.0h	11.2%	25.5%

Embed This Map

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<iframe src="https://weightlossproviderguide.com/research/glp1-affordability-index?embed=true" width="100%" height="600" frameborder="0" title="2026 GLP-1 Affordability Index"></iframe>

Historical dataset

Historical CSV: 50 states plus the District of Columbia, 51 rows and 27 columns. This export uses fixed $349 self-pay and $1,349 Wegovy list-price assumptions. It is not the interactive tool’s 12-scenario dataset.

Download historical CSV

The separate interactive dataset contains all 12 scenarios.

Citation

When referencing this data:

"The 2026 GLP-1 Affordability Index." Weight Loss Provider Guide. weightlossproviderguide.com/research/glp1-affordability-index. Data: BLS, Novo Nordisk, CDC. CC BY 4.0.

In 20 states, a full-time minimum-wage job can’t buy a single month of America’s most prescribed weight loss drug.

Press-Ready Citations

Copy with one click. Pastes as hyperlinked text in Google Docs, email, and CMS platforms.

Weight Loss Provider Guide’s historical GLP-1 Affordability Index export contains 51 jurisdiction rows using fixed $349 self-pay and $1,349 Wegovy list-price assumptions. These inputs differ from the interactive display and are not current treatment quotes. Source: https://weightlossproviderguide.com/research/glp1-affordability-index/data/glp1_master_data.csv

In the historical $1,349 list-price scenario, a $7.25 hourly wage would require approximately 186.1 hours of gross wages to cover one modeled supply. The model uses 160 work hours per four-week period. This illustration excludes taxes, living costs, discounts and additional treatment fees; it does not establish any individual’s actual cost or coverage.

The Double Bind

The historical export uses a top-20 obesity and bottom-half affordability classification. The interactive display uses above-median obesity and above-median labor hours under its selected assumptions. These are different classifications and must not be presented as one current state count. Historical Medicaid fields must be read with their observation date and do not establish an individual’s coverage.

Read the full Double Bind analysis →

Press & Media

Historical state profiles and press kit.

View Historical Press Kit →

Browse by State

Historical state profiles for 50 states and the District of Columbia.

Alabama#4DB Alaska#44 Arizona#25 Arkansas#2DB California#39 Colorado#48 Connecticut#46 Delaware#33 District of Columbia#51 Florida#12 Georgia#17 Hawaii#36 Idaho#16 Illinois#35 Indiana#14DB Iowa#19DB Kansas#13DB Kentucky#7DB Louisiana#5DB Maine#31 Maryland#43 Massachusetts#50 Michigan#26 Minnesota#40 Mississippi#1DB Missouri#18DB Montana#20 Nebraska#21DB Nevada#23 New Hampshire#37 New Jersey#45 New Mexico#9 New York#47 North Carolina#22 North Dakota#32 Ohio#24DB Oklahoma#6DB Oregon#42 Pennsylvania#29 Rhode Island#38 South Carolina#8DB South Dakota#10DB Tennessee#11DB Texas#15 Utah#30 Vermont#34 Virginia#41 Washington#49 West Virginia#3DB Wisconsin#27 Wyoming#28

Historical State Profiles Historical Press Kit Double Bind Report Download Historical CSV

Source: GLP-1 Affordability Index, Weight Loss Provider Guide, 2026. Licensed under CC BY 4.0.