Pharmacist Involvement Speeds Prior Authorization for GLP-1s

When pharmacists take an active role in navigating prior authorizations (PAs) for glucagon-like peptide-1 (GLP-1) medications, they are significantly speeding up the process for patients, according to a study in JMCP.¹

“PAs are intended to ensure appropriate prescription drug use but can often be time-consuming for prescribers, clinic staff, pharmacy teams, and patients,” wrote the authors of a previously published study in JMCP.² “According to a 2024 American Medical Association physician survey, respondents indicated the PA process impacts patient outcomes in a negative way and fuels physician burnout, leading to unnecessary spending and additional office visits.”

This study, conducted at University of Colorado Hospital (UCHealth), evaluated a dedicated team of pharmacists and technicians operating within a centralized PA center. Utilizing a specialized multistep order transmittal technology within the electronic medical record, the team proactively flagged GLP-1 receptor agonist prescriptions needing PAs at the point of prescribing.¹

This proactive approach intercepted requests before they reached the community pharmacy, avoiding the typical delays of retrospective workflows.

READ MORE: How NCPDP Standards Streamline Prior Authorization, Medication Access

The median turnaround time for any PA decision was reduced to just 19.87 hours. Approved PAs achieved a median turnaround time of 47.1 hours, which is nearly a full day faster than the national average of 72 hours that often leaves patients waiting.¹

The Pharmacist’s Immense Role in GLP-1 Management

Beyond pushing paperwork, the UCHealth pharmacists performed clinical interventions. They provided direct patient updates, reviewed clinical charts for insurance eligibility, collaborated with providers to confirm diagnoses, and offered alternative therapy recommendations or copay assistance when plans denied coverage.

Pharmacists also optimized dosing, stepping in to resolve prescribing errors such as incorrect starting doses, improper titration schedules, and double-prescribing conflicts.¹

This rapid support is becoming increasingly vital as GLP-1 usage reaches unprecedented heights. A recent Gallup survey found that the percentage of US adults currently taking a GLP-1 medication for weight loss has surged to 11%, up from 3% in 2024.³

This explosive growth has played a major role in a gradual drop in the US adult obesity rate, from 39.9% in 2022 to 36.4% in 2026, while the national diabetes rate has stabilized. However, this rapid rise has created immense administrative and clinical hurdles.

According to Mike Cohn, vice president of network operations at CoverMyMeds, the high volume and complexity of these requests represent a major bottleneck for care teams that must document body mass index, weight history, and past lifestyle modifications to prove medical necessity. Cohn noted that while electronic PA platforms can provide real-time, plan-specific criteria, many clinics remain bogged down by archaic fax and phone communications.⁴

The Need to Improve PAs for GLP-1s

The administrative burden is particularly pronounced when GLP-1s are prescribed for weight loss rather than diabetes. A prospective study at UC Davis Health quantified this disparity, finding that the hands-on processing time for weight-loss GLP-1 PAs averaged 13.5 minutes per request, more than double the 6.4 minutes required for diabetes indications.²

Furthermore, weight loss PAs faced a dismal 48% approval rate, compared with 90% for diabetes. The UC Davis researchers estimated that processing these highly variable, nonstandardized weight loss requests costs an academic health system an average of $12.80 per PA, potentially draining more than $625,000 annually in administrative labor.

These administrative delays and low approval rates directly translate into clinical access and adherence barriers. In an analysis of specialty pharmacy models, Shields Health Solutions emphasized that navigating step therapy and insurance criteria can be overwhelming, and high out-of-pocket costs, which can range from $900 to $1200 per month without insurance, often lead to high discontinuation rates.⁵

Nearly half of all patients discontinue GLP-1 therapy within the first year, and 3 out of 4 stop by year 2. Shields’ research suggests that integrating clinical pharmacists into specialty care models can reduce the time to therapy initiation to within 24 to 48 hours and connect patients with crucial copay assistance programs.

The Expected Growth of Pharmacists in GLP-1 Management

As clinical indications for GLP-1s expand, the pharmacist’s role will only grow. Lisa Kroon, PharmD, assistant chief pharmacy officer of clinical innovation, education, and research at UCSF Health, pointed out that GLP-1s are no longer just the domain of endocrinologists and primary care physicians. They are now being prescribed by cardiologists, liver specialists, and pulmonologists to treat sleep apnea, metabolic dysfunction-associated steatohepatitis (MASH), and other emerging indications.⁶

Kroon highlighted that pharmacists must be front and center in both medication access and management.

Through telehealth or video visits, pharmacists can provide high-touch care, helping patients manage common gastrointestinal adverse effects like nausea or vomiting during dose titration and providing crucial counseling on combining therapy with long-term lifestyle changes to sustain health benefits. By serving as both administrative navigators and clinical guides, pharmacists are proving indispensable in ensuring that these powerful medications are accessed quickly and used safely.⁶

“In our study, pharmacist involvement in the PA process resulted in a median PA turnaround time of 19.87 hours (25th quartile: 2.15 hours; 75th quartile: 69.6 hours) and an average PA turnaround time of 47.1 hours,” concluded the authors of the current study.¹ “This study has provided a strong foundation for future research and policy development aimed at further quantifying the impact and value of the pharmacist in PA process and GLP-1 RA management.”

READ MORE: Experts Uncertain of GLP-1s’ Long-Term Clinical Benefits

REFERENCES

1. Huddleston H, Martinez J, Cook J, et al. Assessing the impact of pharmacist-led interventions on glucagon-like peptide 1 receptor agonist access and treatment outcomes. JMCP. 2026;32(6). doi:10.18553/jmcp.2026.32.6.651

2. Pham D, Duby JJ, Setoudeh S, et al. Administrative costs of prior authorizations for glucagon-like peptide-1 agonists. JMCP. 2026 Mar;32(3):292-299. doi: 10.18553/jmcp.2026.32.3.292

3. Witters D. In U.S., GLP-1 usage reaches new high. Gallup. July 7, 2026. Accessed August 13, 2026. https://news.gallup.com/poll/712157/glp-usage-reaches-new-high.aspx

4. Ferruggia K, Cohn M. Navigating GLP-1 medications: prior authorization challenges and solutions. Pharmacy Times. May 27, 2025. Accessed August 13, 2026. https://www.pharmacytimes.com/view/navigating-glp-1-medications-prior-authorization-challenges-and-solutions

5. Addressing GLP-1 access and adherence challenges with specialty pharmacy solutions. Shields Health Solutions. April 2, 2025. Accessed August 13, 2026. https://shieldshealthsolutions.com/glp1-access-adherence-specialty-pharmacy/

6. Revah S. Q&A: how UCSF pharmacists are guiding safe and effective GLP-1 use. University of California San Francisco School of Pharmacy. November 26, 2025. Accessed August 13, 2026. https://pharmacy.ucsf.edu/news/2025/11/qa-how-ucsf-pharmacists-are-guiding-safe-and-effective-glp-1-use