The Geography of GLP-1 Prescriptions
When analyzing prescription rates for GLP-1 agonists, a class of drugs that includes Ozempic, a clear regional pattern emerges. Kentucky stands out with the highest rate, dispensing approximately 21 prescriptions for every 1,000 residents [1.2.4, 1.2.5]. Following Kentucky are West Virginia (18.9 per 1,000), Alaska (17.5 per 1,000), Mississippi (16.1 per 1,000), and Louisiana (15.4 per 1,000) [1.2.5, 1.2.9]. These figures, based on an analysis of 1.9 billion insurance claims, highlight a concentration of use in the Southern and Appalachian regions [1.2.4]. Conversely, states like Rhode Island (3.7 per 1,000) and Massachusetts (4.0 per 1,000) show the lowest rates of use [1.2.1, 1.2.9].
It's important to distinguish between prescription rates and online search interest. While Southern states lead in actual prescriptions, states like New York and Nevada show high search interest per capita, indicating strong public curiosity driven by different factors, such as lifestyle and media influence [1.2.6].
Key Drivers of Ozempic Use
The high prescription rates in states like Kentucky and West Virginia are not coincidental. Several interconnected factors contribute to this trend:
- High Rates of Type 2 Diabetes: Ozempic is FDA-approved for the management of type 2 diabetes [1.6.7]. The Southern states with high GLP-1 prescription rates also have the highest occurrences of diabetes [1.6.6]. For instance, West Virginia has a diabetes prevalence of 15.2%, and Mississippi's is 14.6% [1.3.7]. Since most insurance claims cover GLP-1 drugs for diabetes rather than for weight loss alone, the high prevalence of this condition is a primary driver [1.6.6].
- Prevalence of Obesity: There is a strong correlation between states with high obesity rates and those with high GLP-1 prescriptions [1.6.6]. In 2023, the Midwest (36.0%) and the South (34.7%) had the highest prevalence of adult obesity in the nation [1.4.1]. West Virginia has the highest adult obesity rate in the U.S. at 41.2%, with Mississippi (40.1%) and Louisiana (39.9%) also ranking near the top [1.4.3]. These conditions often lead to the prescription of medications like Ozempic, either for diabetes management or, increasingly, for weight management [1.3.2].
- Healthcare Access and Insurance: Disparities in healthcare access and insurance coverage also play a role [1.3.2, 1.6.6]. States with lower uninsured rates, like Kentucky (6.2%), may have better access to these medications through insurance [1.3.7]. However, the high cost of these drugs—often between $900 and $1,400 per month—can be a significant barrier, especially for those without comprehensive insurance or in lower-income brackets [1.6.1, 1.6.8]. This cost barrier might also explain why a state like California has a lower-than-expected prescription rate based on claims data, as it doesn't account for out-of-pocket purchases [1.2.5].
- Social and Media Influence: The popularity of Ozempic and similar drugs has been amplified by social media and celebrity endorsements, leading to increased demand for off-label use for weight loss [1.6.2, 1.6.9]. This buzz contributes to nationwide shortages and raises ethical concerns about equity and access for patients with diabetes [1.6.1, 1.6.4].
Comparing GLP-1 Medications
Ozempic is part of a growing class of GLP-1 receptor agonists. While often used as a catch-all term, it has distinct counterparts, each with specific FDA approvals and characteristics.
| Feature | Ozempic | Wegovy | Mounjaro (Zepbound) |
|---|---|---|---|
| Active Ingredient | Semaglutide [1.3.1] | Semaglutide [1.3.1] | Tirzepatide [1.3.1] |
| Primary FDA Approval | Type 2 Diabetes [1.6.7] | Chronic Weight Management [1.3.1] | Type 2 Diabetes (Mounjaro), Chronic Weight Management (Zepbound) [1.3.1] |
| Administration | Weekly Injection [1.3.1] | Weekly Injection [1.3.1] | Weekly Injection [1.3.1] |
| Mechanism | GLP-1 Agonist [1.3.1] | GLP-1 Agonist [1.3.1] | Dual GLP-1/GIP Agonist [1.3.1] |
Originally approved for diabetes, Ozempic's weight loss side effect led to massive public interest [1.6.9]. This demand spurred the approval of Wegovy, a higher-dose semaglutide formulation specifically for weight management [1.3.1]. Mounjaro and its weight-loss-indicated counterpart, Zepbound, work on two receptors (GLP-1 and GIP), which some studies suggest may lead to greater weight loss.
Conclusion
The answer to "What state uses the most Ozempic?" points to Kentucky when measured by per capita prescriptions based on insurance claims [1.2.1, 1.2.3]. The broader trend shows that Southern and Appalachian states lead in the use of GLP-1 medications, a pattern strongly linked to the high prevalence of type 2 diabetes and obesity in these regions [1.3.7, 1.4.1]. While media trends and off-label demand contribute to the national conversation, the on-the-ground data reveals that these powerful medications are most prescribed where the underlying medical needs are greatest, though issues of cost and equitable access remain significant challenges [1.6.1].
For more information on adult obesity prevalence, you can visit the CDC's resource page.
