Prices are falling for the popular obesity treatments Wegovy and Zepbound, but steady access to the drugs remains challenging.

The medications still amount to around $500 a month for users without insurance — out of reach for many patients. And even for people with insurance, coverage remains uneven.

Doctors say the situation forces them to get creative in treating patients, but there’s hope that prices may fall more in the future.

Zepbound brought in $2.3 billion in U.S. sales during this year’s first quarter, making it one of drugmaker Eli Lilly’s best sellers.

Novo Nordisk says Wegovy has about 200,000 weekly prescriptions in the U.S., where it brought in nearly $1.9 billion in first-quarter sales.

Mercer, a benefits consultant, says more businesses with 500 or more employees are adding coverage of the injected drugs for their workers and family members.

And Novo says 85% of its patients who have coverage in the U.S. pay $25 or less monthly.

Plus some patients with diabetes can get coverage of the GLP-1 drugs Ozempic and Mounjaro from Novo and Lilly that are approved to treat that condition.

But most state and federally funded Medicaid programs don’t cover the drugs for obesity, and neither does the federal program Medicare.

Even the plans that cover the drugs often pay only a portion of the bill, exposing patients to hundreds of dollars in monthly costs.

Bill-payers like employers are nervous about drugs that might be used by a lot of people indefinitely.

Some big employers have dropped coverage of the drugs because of the expense. Pharmacy benefit managers, or PBMs, also are starting to pick one brand over the other as they negotiate deals with the drugmakers.

One of the nation’s largest PBMs, run by CVS Health, dropped Zepbound from its national formulary, or list of covered drugs, on July 1 in favor of Wegovy.