Top GLP-1 Drugs by Reported Medicaid Prescriptions in 2025

The top GLP-1 drugs in this analysis are the 12 included product groups with the most reported Medicaid-reimbursed prescriptions in the 2025 national aggregate records. Ozempic ranks first, Wegovy second and Trulicity third in the computed 2025 national Medicaid ranking. This measures reported prescriptions in Medicaid data-not clinical superiority, sales, or all-payer U.S. market share.

The national reported total across the included product groups is 11,255,983 prescriptions. The source measures Medicaid-reimbursed prescriptions, not unique patients or all U.S. prescriptions. In the national extract, 85 rows were suppressed or unavailable; those counts are not imputed.

Table of contents

• The 2025 Medicaid drug ranking
• What the 2025 ranking shows
• What the counts measure
• Method and data limitations
• How to interpret the product groups
• Frequently asked questions
• The takeaway
• Explore structured public healthcare data
• Sources

The 2025 Medicaid drug ranking

The table ranks included product groups by reported national Medicaid prescription counts in 2025. It includes GLP-1 products and the related tirzepatide products Mounjaro and Zepbound, which are dual GIP/GLP-1 receptor agonists. The selected groups include brand-labelled and ingredient-labelled records: Ozempic, Wegovy, Trulicity, Zepbound, Mounjaro, Rybelsus, Liraglutide-labelled products, Victoza, Saxenda, Bydureon-labelled products, Byetta, Exenatide-labelled products. Fixed insulin combinations, supplements and compounded or unreported products are excluded.

What the 2025 ranking shows

The ranking covers GLP-1 products and related tirzepatide products. Ozempic leads with 3,695,736 reported prescriptions, followed by Wegovy with 1,995,718 and Trulicity with 1,940,795. Zepbound and Mounjaro, both containing tirzepatide, rank fourth and fifth.

Mounjaro and Zepbound are dual GIP/GLP-1 receptor agonists, not GLP-1-only agonists. They are explicitly included in this analysis, and their dual-agonist classification remains important when describing the scope. FDA NDC records identify tirzepatide for both brands and list pharmacologic classes related to GLP-1 and glucose-dependent insulinotropic polypeptide receptors.

The results aggregate reported prescriptions across included product groups, NDC packages, calendar quarters 1-4, and fee-for-service and managed-care utilization records. The national ranking uses aggregate rows coded XX; it does not add national and state rows together. The 11,255,983 total applies to the included product groups, not every drug or every prescription in Medicaid.

What the counts measure

CMS describes State Drug Utilization Data (SDUD) as data reported by states for covered outpatient drugs paid for by state Medicaid agencies. The SDUD data dictionary defines “No. of Prescriptions” as prescriptions reimbursed by Medicaid to pharmacists for an NDC during the reporting period. It identifies fee-for-service utilization and, from 2010 onward, managed-care organization utilization.

For this analysis, the result is a calendar-year 2025 aggregation of reported Medicaid-reimbursed prescriptions. It is not a count of unique people: one person may have more than one prescription, and the dataset does not identify why a prescription was written. Nor are the figures standardized 30-day-equivalent fills, sales, manufacturer revenue, or total use across commercial insurance, Medicare, and cash-pay channels. They cannot establish all-payer U.S. market leadership.

The ranking is not a measure of treatment effectiveness or a source of prescribing advice. A prescription record alone does not establish a patient’s diagnosis, treatment response, or clinical circumstances. The narrower question it answers is which included product groups had the most reported Medicaid prescriptions in the 2025 national aggregate records.

Method and data limitations

The exact source is the 2025 Medicaid State Drug Utilization Data CSV, July 2026 revision, retrieved on 21 October 2026. The source counts were unchanged.

The analysis uses the 2025 SDUD July 2026 revision, retrieved on 21 October 2026. It sums published prescription counts across calendar quarters and included NDC-11 packages, using fee-for-service and managed-care records. Product groups were assigned using the first ten characters of the FDA list-name field and an explicit prefix map; generically labelled records were not assigned brand names by inference.

Counts flagged as suppressed or missing were excluded rather than treated as zero or imputed. A total of 85 national extract rows were suppressed or unavailable. The reported total therefore reflects available counts across the included groups; it is not an estimate adjusted to fill gaps. A missing or suppressed count should not be interpreted as evidence of no utilization.

The grouping method has boundaries. Fixed insulin combinations, supplements, and compounded or unreported products are excluded. Product-name mapping is based on historical records and does not establish whether a product is currently marketed or approved. The source is also subject to reporting and suppression limitations.

National results should not be confused with state-level rankings or product price comparisons. For a separate geographic view, see GLP-1 prescriptions by state. Price questions require different data and a separate time frame; see GLP-1 price changes for 2027.

How to interpret the product groups

The top three positions show that semaglutide and dulaglutide product groups have the largest reported counts in this ranking. Ozempic and Wegovy rank first and second, while Rybelsus appears later in the list. The analysis ranks product groups separately; it does not combine all semaglutide records into an ingredient-level total. A shared ingredient also does not make products interchangeable for interpreting these counts.

Zepbound ranks ahead of Mounjaro in the reported Medicaid records. That ordering describes the observed counts only; it does not establish the reason for the difference or imply a change in treatment choice.

Counts fall substantially after the leading groups, and the lower end includes records grouped under ingredient-labelled product names as well as brand names. This reflects the analysis’s product-name grouping approach, not a judgment about the products. Comparisons should be read alongside the grouping rules and the suppressed or unavailable rows.

Frequently asked questions

These answers clarify what the ranking measures, how its product scope is defined, and what information is-and is not-available in QOPE’s Medicaid Rebate Drugs dataset.

Does “top” mean best-performing treatment?

No. “Top” refers only to reported Medicaid-reimbursed prescription counts in the 2025 national aggregate records. It does not mean most effective, safest, or clinically preferred.

Are these counts unique patients?

No. They are prescription counts, not patient counts. The SDUD measure records prescriptions reimbursed by Medicaid to pharmacists during the reporting period.

Why are Mounjaro and Zepbound included?

Both contain tirzepatide and are dual GIP/GLP-1 receptor agonists. They are explicitly included in this analysis as related tirzepatide products, while retaining their dual-agonist classification rather than describing them as GLP-1-only products.

Can these records be used to look up prescription counts in QOPE?

No. QOPE’s Medicaid Rebate Drugs dataset provides product-related fields, including NDC, product name, labeler, drug category, and other listed product attributes. It is a product catalog, not a prescription-utilization dataset, and does not supply the prescription ranking presented here.

The dataset appends quarterly product rows and weekly newly reported rows without deduplication. Year and quarter are available on quarterly rows, while weekly rows lack those fields. Some other attributes are also not populated on every record.

The takeaway

Ozempic ranks first, Wegovy second and Trulicity third in the computed 2025 national Medicaid ranking. The included product groups total 11,255,983 reported prescriptions, while 85 national extract rows were suppressed or unavailable and not imputed. These figures describe Medicaid-reimbursed prescriptions—not unique patients, clinical superiority, or all U.S. prescriptions.

Explore structured public healthcare data

Visit Explore structured public healthcare data for the Medicaid Rebate Drugs dataset.

Sources

• Medicaid State Drug Utilization Data
• FDA National Drug Code Directory