Glucagon-like peptide-1 (GLP-1) medications have become a dominant driver of drug spending, with total expenditures in the United States rising to $71.7 billion in 2023, up from $13.7 billion five years earlier. More recent data show that GLP-1s are now the largest and fastest-growing drug category, driven by expanding indications and sustained demand for obesity treatment. As these medications reshape drug spending and clinical practice, payers face mounting pressure to make coverage, utilization management, and contracting decisions—but in this rapidly shifting reimbursement landscape, there is a lack of long-term data available to inform strategic choices.
Payers will benefit from evaluating not only drug unit cost, but also total cost of care, adherence durability, and long-term clinical return on investment. This article provides a practical overview of the current GLP-1 environment, spanning coverage obligations, utilization management strategies, and cost dynamics. The aim is to help payers, employers, and health plans navigate an ecosystem where federal policy, manufacturer pricing, and patient demand are all in flux simultaneously.
The paper covers the following key discussion topics. Download the full paper here.
- Background: GLP-1 definition, market size, and current and future products
- Benefit design and management strategies: Three key levers influencing the long-term affordability of the drug class
- Implementation uncertainties and considerations: Review of coverage, utilization management, and cost
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