Q&A: The Pharmacist’s Burden Associated With Dispensing GLP-1s

Recent drug development has led to the unprecedented cardiometabolic success of glucagon-like peptide-1 (GLP-1) medications for patients with diabetes, obesity, sleep apnea, and more. However, as these drugs continue to rise in popularity, pharmacists have shared real-world experiences regarding the sheer difficulty in helping patients manage their benefits for these drugs.

“All of [these challenges] amount to a huge administrative nightmare, in my opinion, for those community pharmacists and pharmacies having to help navigate patients through an amazing drug,” Rae McMahan, senior vice president of payor solutions at Prescryptive Health, told Drug Topics. “It's at a higher price point and so many varying degrees of coverage via insurance and direct access and coupons make it really challenging.”

In part 2 of our interview with Rae McMahan, she discusses the pharmacists’ role surrounding constant sentiments on rising GLP-1 use and costs. | image credit: russell102 / stock.adobe.com

Amid this increased popularity and direct-to-consumer advertising for GLP-1s, pharmacists have been forced to keep an optimal level of knowledge on these drugs’ affects, costs, and coverage in order to navigate patients through prescription drug regimens. However, if pharmacists believe these patient burdens are too much, according to McMahan, pharmacies may choose to avoid dispensing a potentially life-saving drug.

Read through part 2 of our interview with McMahan as she discusses the pharmacists’ role surrounding constant sentiments on rising GLP-1 use and costs.

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

Drug Topics: Can you start by summarizing the current trends surrounding GLP-1 use and cost? What events or trends have led to the public’s current understanding of GLP-1s and their effects?

Rae McMahan: [There are] certainly more drugs than market and more drugs coming to market. A lot of marketing around these specific products, not only for weight health but other indications that are coming, [is] going direct to consumers, whether they meet the clinical criteria or not.

I would say, a third component of this is a number of companies that look to prescribe these medications, either these specific pharmaceutical agents or those that are compounded. Even though the access to these medications, they have fixed a lot of the issues, we still do see some companies utilizing compounded medication with the B12 additive agents. So, still a lot of conversation around the right products and a big part being affordability.

Drug Topics: How have community pharmacies and their pharmacists been impacted by the increase in GLP-1 popularity?

Rae McMahan: I give those pharmacies a lot of credit, because I think you have a full gamut of patients that are looking to get these medications. Really, you could say that they're miracle drugs; they really provide help to those that need it. But you will also have those that don't necessarily meet those clinical parameters to have it covered under insurance. I've seen pharmacists in action, and they're trying to navigate whether the drug is covered or not covered. What benefit is it covered under? Is it a limited benefit? Is it their pharmacy benefit, or is it even something else? And then, is there a prior authorization at the same time? Do they have to go through the prior authorization before they can get the medication? Then on top of that, is there a coupon that they should be utilizing to afford the medication?

All of those amount to a huge administrative nightmare, in my opinion, for those community pharmacists and pharmacies having to help navigate patients through an amazing drug. It's at a higher price point and so many varying degrees of coverage via insurance and direct access and coupons make it really challenging. I can imagine that even if their reimbursement is a little bit higher, these take so much time, I can't imagine that [pharmacists] would say that they're fruitful for them to even fulfill in some capacity because of the challenges around them.

READ MORE: GLP-1 No Longer on FDA’s Drug Shortage List

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