Q&A: How Increased Popularity, Minimal Access to GLP-1s Create Patient Barriers

With glucagon-like peptide-1 (GLP-1) medications continuously on the rise as the prescription drug market’s most sought-after medication class, many stakeholders within pharmacy have been forced to address issues in advertising, access, costs, and more. However, as these issues continue to go unsolved across the greater population, experts are calling to address how challenges behind GLP-1 dispensing impact patient outcomes.

“There are varying degrees of clinical parameters that patients should meet to be on these medications,” Rae McMahan, senior vice president of payor solutions at Prescryptive Health, told Drug Topics. “One thing that I am lacking to see, and I would really love to see someone do this, is a correlation between those that meet the clinical endpoints for that but equating that to specifically what their copay would be for this medication.”

McMahan, who’s been working with her team to better understand challenges in GLP-1 access and costs, recently joined Drug Topics to discuss the growing need to address these barriers and improve the lives of patients needing these drugs. According to McMahan, GLP-1 access should be reserved for the patients that need them the most.

McMahan addresses challenges and patient barriers in GLP-1 access and development. | image credit: Gecko Studio / stock.adobe.com

Discussions around these challenges are ongoing amid an increased popularity for the drug class. Furthermore, increased costs and decreased availability can translate to patients in better socioeconomic and less need for GLP-1s with greater access than lower-income patients with a greater need for these medications.

Between a variety of challenges experts have yet to address, as well as increased advertising and common knowledge of the drug class, stakeholders like McMahan and her team have put pressure on the challenges existing in the GLP-1 space. Read along for part 1 of our interview with McMahan, who addresses challenges and patient barriers in GLP-1 access and development.

READ MORE: GLP-1 Titration Remains Persistent Challenge Among Patients With Obesity

Drug Topics: How has increased advertising for GLP-1 medications translated to patient outcomes as well as the public’s overall perception of this drug class?

Rae McMahan: I think that the hard thing about it is [GLP-1s have] certainly alerted potential patients to the medication. There are varying degrees of clinical parameters that patients should meet to be on these medications. One thing that I am lacking to see, and I would really love to see someone do this, is a correlation between those that meet the clinical endpoints for that—meaning they meet the [body mass index] requirements primarily, and sleep apnea, other comorbid conditions—but equating that to specifically what their copay would be for this medication.

There's a lot of research out there about [how] there is not adherence measures to these medications, and that they have not met their specific outcomes. I believe that the primary driver of that is access to affordable copays and/or coupons that would allow that member to continue to get the drug. I have not seen that, but I feel that that is one of the biggest barriers to make sure that the right person intended for the medication and meeting those clinical parameters can afford it as well and know where they can get it. That's a challenge that we're facing today.

Drug Topics: What issues are ongoing in regard to GLP-1 access and development, and how will these issues potentially impact the greater patient population?

Rae McMahan: I think that some of the challenges are just, how are these drugs reimbursed? Are they covered under insurance? Do I have to pay cash? Do I have to be in a weight-health program to access these medications? What pharmacy do I go to to get the medication, and will my insurance cover it or do I need to use a coupon at the same time? How do I even enroll in that coupon? And what do I do if I need to increase my dose, decrease the dose, and then I'm having side effects—most primarily nausea-related conditions, and ensuring that they have the adjunctive therapy to help out with some of those other side effects that can happen when they're taking this medication?

That's one of the biggest issues is around the access and also helping employers determine who is the right population within their employer base to have access to these medications. How can they afford it as an employer? If we think about just the cost of these medications, between $500 and $1000 per month, if the member has to pay a significant portion of that, I would say those that generally really need it are not necessarily in a position to pay for it.

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