A study examining real-world data from more than 3.7 million individuals reveals that patients prescribed glucagon-like peptide-1 (GLP-1) receptor agonists for obesity or type 2 diabetes mellitus (T2DM) incur significantly higher pharmacy costs beyond the price of the GLP-1 drugs themselves.

Researchers used national pharmacy and medical claims data from 2014 to 2024 to evaluate non-GLP-1 medication utilization in over 1.1 million GLP-1 initiators compared with 2.6 million matched controls. The study found that average non-GLP-1 pharmacy costs for GLP-1 users were $1449, $2390, and $2812 higher than controls in years 1, 2, and 3 after initiation, respectively.

The increased cost burden was partly attributed to the management of gastrointestinal side effects commonly associated with GLP-1 therapy, including constipation, nausea, vomiting, and gastroesophageal reflux disease (GERD). Notably, treatment rates for GERD-related respiratory symptoms—such as cough and nasal congestion—were also significantly higher among GLP-1 users.

Side effect–related medication use increased in proportion to GLP-1 treatment duration. For example, GERD treatment rates climbed from 25% to 32% in patients with over 24 months of GLP-1 persistence, compared to 22% in matched controls.

The findings underscore the importance for payers and providers to account for the downstream costs of managing GLP-1–related side effects when considering these therapies for patients. While GLP-1s are effective for metabolic disease management, their broader impact on pharmacy utilization may reshape cost-benefit analyses in formulary decisions.

Reference

Anatale-Tardiff L, Margiotta C, Swami S, et al. Real-world trends in pharmacy utilization among commercially insured individuals treated with glucagon-like peptide-1 (GLP-1) receptor agonists, 2014-2024. Presented at: AMCP 2025; March 31-April 3; Houston, TX; Abstract E18.