Researchers Propose Solutions to Improve GLP-1 RA Access

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Cost-sharing and education may improve access to GLP-1 therapies for obesity, but systemic barriers remain, requiring broader policy and clinical reforms.

Cost-sharing interventions and patient education can help improve access to GLP-1 receptor agonists for patients with obesity, according to an abstract presented at the AACE Annual Meeting 2025.

Cost-Sharing Program Benefits Patient

Rashida Khan, PhD, and colleagues presented a case in which a 56-year-old African American woman with a BMI of 40 kg/m² was denied insurance coverage for GLP-1 receptor agonist therapy. The patient was enrolled in a cost-sharing program that reduced her out-of-pocket expenses by 70%, allowing her to access the medication. In addition, she received counseling on medication use, lifestyle changes, and nutritional goals.

After six months, the patient demonstrated improvements in BMI, glycemic control, joint pain, and mobility and “reported high satisfaction with the care plan and significant improvements in quality of life.”

The researchers said their case highlights the importance of addressing systemic barriers that prevent patients from accessing obesity care. They also noted that even though the cost-sharing intervention was effective, long-term adherence to obesity treatment remains challenging. They recommended expanding cost-sharing programs and ongoing patient support to build a scalable, sustainable solution for larger populations.

“This case highlights the potential for replicable, equity-focused strategies to improve access to obesity care and reduce health disparities,” Dr. Khan and colleagues said.

Other Persistent Barriers & Potential Solutions

In another article not presented at the meeting, Stephanie W. Waldrop, MD, and colleagues identified barriers to obesity medications more broadly—and potential solutions. They published their insights in Nature Medicine.

Healthcare Professionals

Among healthcare professionals, potential barriers include lack of education, safety concerns, and obesity stigma/weight bias. Proposed solutions include:

• Improved training within medical school and residency
• Knowledge acquisition via CME requirements
• Cultural competency training
• Training in implicit bias, weight bias, and the effects of weight stigmatization
• Use of people-first language and neutral weight terminology

Patients

Patients may also have safety concerns, be reluctant to engage with agents for which long-term use is required, or face high costs.

“Society all too often conceptualizes obesity as a problem of individual willpower, which could reduce the demand for pharmacological treatments among those who are most affected and who have the potential for greatest benefit,” the researchers said.

Solutions include the following:

• Enable patient understanding of obesity as a chronic disease requiring long-term therapy
• Improve healthcare professional efficacy in educating patients on the risks and benefits of starting and continuing anti-obesity pharmacotherapy
• Improve access, regardless of ability to pay, through better insurance coverage and third-party payer discounts

Insurance Providers

Long-term use and high costs also present challenges for insurance coverage.

“Medicare, which covers people over 65 years in the USA, explicitly prohibits coverage of anti-obesity pharmacotherapy,” Dr. Waldrop and colleagues said. “Seventeen states include anti-obesity medications under Medicaid, which provides healthcare for people with low incomes, but only nine of these have preferred drug plans that cover the newer agents.”

They proposed the following solutions:

• Facilitate greater access to improve cost-sharing
• Remove anti-obesity pharmacotherapy with less efficacy and undesirable side effects (such as orlistat)

Governmental Regulatory Agencies

Potential solutions addressing stigma and safety concerns among governmental regulatory agencies include the following:

• Follow medical society and drug manufacturer guidelines
• Evaluate more clinical data on safety and efficacy endpoints to support long-term use

Drug Manufacturers

Lastly, drug manufacturers can help address the broader healthcare system’s concerns over safety and long-term use by conducting more studies on long-term use, thereby providing more data to patients, healthcare professionals, and evaluators.

“Health is a social good, and thus society has an obligation to provide health services that address the needs of all. GLP-1 agonists are effective treatments for weight management, and although regulatory bodies and medical providers are on the right path, we have a long way to go,” the researchers concluded.