TRENDS IN THE USE OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS (GLP-1 RAS), DIAGNOSIS REQUIREMENTS, AND BENEFICIARY USE AMONG US SELF-INSURED EMPLOYERS
Author(s)
Richard A. Brook, MBA, MS1, Stephen A Schramm, MA2, Alek A Drnach, MS2, Eric M. Rosenberg, MA, MA2;
1Better Health Worldwide, President (BH-WW), Newfoundland, NJ, USA, 2WorkPartners, LLC, Integrated Analytics, Pittsburgh, PA, USA
1Better Health Worldwide, President (BH-WW), Newfoundland, NJ, USA, 2WorkPartners, LLC, Integrated Analytics, Pittsburgh, PA, USA
OBJECTIVES: Use of Glucagon-like peptide-1 receptor agonists (GLP-1RAs) continues to increase in the United States (US). Insurers often require a diagnosis prior to use and coverage by the payers before dispensing. Self-insured employers use a variety of insurers and have policies that allow use of GLP-1RAs, usually requiring a diagnosis (Dx). We examined utilization trends across US self-insured employers, for GLP-1RAs use (overall, for obesity-GLP-1RAs, and for diabetes-GLP-1RAs) and calculated the % of members using each type of GLP-1RA and explored the employer impact.
METHODS: We analyzed four large-employers in Workpartners Research Reference Database (RRDb,Jan-2021—Sep-2025). Beneficiaries (Employees, spouses/partners, and dependents) with medical/Rx coverage and GLP-1RA use each year were examined for indication, and % of beneficiary type receiving therapy. GLP-1RAs were captured based on each year’s 1st claim.
RESULTS: The GLP-1RA population continues to increase. Over the 5-year time (1.8 million beneficiary-years) 3.2% (58,633) used GLP-1RAs (Diabetes=2.4%,Obesity=0.9%). 19.5% of overall GLP-1RA users lacked Dxs for indicated conditions, with 3 employers’ GLP-1RA use increasing since 2021. Dependent GLP-1RA use increased annually for all employers, averaging <0.2%. Rates of utilization for employees:spouses differed across employers, from 1.2x to 0.5x for the lowest median wage employer. For the 43,291 employees prescribed Diabetic-GLP-1RAs, 82.5% had a Diabetes-Dxs, 22.8% had an Obesity-Dxs and 12.5% lacked a Dx for any GLP-1RA indication. For the 15,971 employees prescribed Obesity-GLP-1RAs, 45.3% had Obesity-Dxs, 29.1% had Diabetes-Dxs, and 39.1% lacked a Dx for any GLP-1RA indication.
CONCLUSIONS: Despite diagnosis restrictions, GLP‑1RA utilization continues to rise among self‑insured employers. Coverage policies and diagnosis requirements vary substantially across employers, underscoring the need for analyses that explicitly account for employer‑level policy differences. Communicating these findings to employers enhances their understanding of how coverage decisions shape utilization patterns and associated costs.
METHODS: We analyzed four large-employers in Workpartners Research Reference Database (RRDb,Jan-2021—Sep-2025). Beneficiaries (Employees, spouses/partners, and dependents) with medical/Rx coverage and GLP-1RA use each year were examined for indication, and % of beneficiary type receiving therapy. GLP-1RAs were captured based on each year’s 1st claim.
RESULTS: The GLP-1RA population continues to increase. Over the 5-year time (1.8 million beneficiary-years) 3.2% (58,633) used GLP-1RAs (Diabetes=2.4%,Obesity=0.9%). 19.5% of overall GLP-1RA users lacked Dxs for indicated conditions, with 3 employers’ GLP-1RA use increasing since 2021. Dependent GLP-1RA use increased annually for all employers, averaging <0.2%. Rates of utilization for employees:spouses differed across employers, from 1.2x to 0.5x for the lowest median wage employer. For the 43,291 employees prescribed Diabetic-GLP-1RAs, 82.5% had a Diabetes-Dxs, 22.8% had an Obesity-Dxs and 12.5% lacked a Dx for any GLP-1RA indication. For the 15,971 employees prescribed Obesity-GLP-1RAs, 45.3% had Obesity-Dxs, 29.1% had Diabetes-Dxs, and 39.1% lacked a Dx for any GLP-1RA indication.
CONCLUSIONS: Despite diagnosis restrictions, GLP‑1RA utilization continues to rise among self‑insured employers. Coverage policies and diagnosis requirements vary substantially across employers, underscoring the need for analyses that explicitly account for employer‑level policy differences. Communicating these findings to employers enhances their understanding of how coverage decisions shape utilization patterns and associated costs.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD5
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)