Payer Coverage Trends and Access to GLP-1 Drugs for Weight ‌loss

Updated May‍ 29, 2025
​

The ⁢increasing prevalence of obesity is driving interest in glucagon-like peptide-1 receptor agonists (GLP-1 RA) as a pharmacological treatment option. By 2023, the Centers for Disease Control and Prevention (CDC) reported that over a third of adults in ​23 states were ‍obese. Global projections estimate that 1⁢ billion people will be living with obesity by 2030.

Despite the promise of GLP-1 drugs in addressing obesity, access remains a key issue. While payer coverage ​appears to be gradually​ increasing, patient abandonment rates and out-of-pocket costs continue to pose challenges. Cost is one potential reason why ​patients do not pick up their⁣ medication,⁤ but further research is needed.

Data indicates that abandonment rates for patients approved ‍for GLP-1 use remained steady between 2021 and‍ 2022,at roughly 23%. Though, in 2023, this rate climbed to 28.5%. Although the rate decreased to⁣ 17.3% in 2024, the data only covered through early October.

A slight decrease in patient out-of-pocket costs for both approved and reversed claims was observed. This analysis ⁢did not include a comprehensive breakdown of all patient assistance programs but⁢ was⁢ intended to provide a high-level view of costs.

Pull-through rates for both rejections and prior ‍authorizations steadily increased from 16.3% in 2021 to 25.1% in 2023, before slightly declining to ⁤24.3% in 2024. On average, it took 7.19 days to overcome a rejection, with a median of 6 days. Overcoming ​a prior authorization rejection took an average of 8.07 days, with a median of ⁣7 days.

What’s next

Continued​ monitoring of payer policies and further⁣ research into patient access barriers are needed‍ to fully understand the impact on obesity prevalence in the United ‍States. Future studies​ should also examine trends ​in patient claims for associated comorbidities.