THE PATTERNS OF COUPON OFFSETS IN GLUCAGON-LIKE PEPTIDE AGONIST USE:EVIDENCE FROM NATIONAL, ALL-PAYER PHARMACY CLAIMS
Author(s)
Minji Kim1, Manuel Hermosilla, PhD2, So-Yeon Kang, PhD, MBA, MPH3;
1Johns Hopkins Bloomberg School of Public Health, USA, 2University of Illinois at Chicago, Chicago, IL, USA, 3Georgetown University School of Health, Washington, DC, USA
1Johns Hopkins Bloomberg School of Public Health, USA, 2University of Illinois at Chicago, Chicago, IL, USA, 3Georgetown University School of Health, Washington, DC, USA
OBJECTIVES: To examine manufacturer-sponsored coupon utilization patterns and longitudinal changes in payer drug spending, coupon offsets, and patient OOP costs among commercially insured adults in the United States (2017-2024).
METHODS: We conducted a retrospective cohort study using a 10% random sample of IQVIA’s Formulary Impact Analyzer (FIA), capturing nationwide, all-payer retail and mail-order pharmacy claims from 2017 to 2024. Payer drug spending, coupon offsets, and patient OOP costs were tracked longitudinally from each patient’s first GLP-1 RA fill. We characterized coupon patterns by type (free trial vs. copay assistance) using descriptive statistics and quantified associations with discontinuation using Cox proportional hazards models.
RESULTS: Among 359,029 commercially insured adults who filled a GLP-1 RA, 7.7% used manufacturer coupons. Coupon use was more common among individuals without diabetes evidence, younger adults, females, and tirzepatide users. Coupon users remained on therapy longer than non-users (median 6.4 months [IQR 1.9-12.4] vs. 2.7 months [IQR 0-7.7]). Median coupon offsets were $955 (IQR 567-983) for free trials and $50 (IQR 0-150) for copay assistance. Post-coupon median patient OOP costs were $27 in both groups, though variability was higher among coupon users (IQR 26-95 vs. 14-28). Coupons applied to 5.4% of claims through month 8, declining to 3.9% thereafter, with free trial use showing the sharpest drop. As coupon offsets waned, payer spending and patient OOP costs rose modestly (p < 0.001).
CONCLUSIONS: Manufacturer coupons for GLP-1 RAs are concentrated early in treatment and decline rapidly, suggesting these programs facilitate initiation rather than long-term adherence. After month 8, remaining drug costs increasingly shift to patients and payers.
METHODS: We conducted a retrospective cohort study using a 10% random sample of IQVIA’s Formulary Impact Analyzer (FIA), capturing nationwide, all-payer retail and mail-order pharmacy claims from 2017 to 2024. Payer drug spending, coupon offsets, and patient OOP costs were tracked longitudinally from each patient’s first GLP-1 RA fill. We characterized coupon patterns by type (free trial vs. copay assistance) using descriptive statistics and quantified associations with discontinuation using Cox proportional hazards models.
RESULTS: Among 359,029 commercially insured adults who filled a GLP-1 RA, 7.7% used manufacturer coupons. Coupon use was more common among individuals without diabetes evidence, younger adults, females, and tirzepatide users. Coupon users remained on therapy longer than non-users (median 6.4 months [IQR 1.9-12.4] vs. 2.7 months [IQR 0-7.7]). Median coupon offsets were $955 (IQR 567-983) for free trials and $50 (IQR 0-150) for copay assistance. Post-coupon median patient OOP costs were $27 in both groups, though variability was higher among coupon users (IQR 26-95 vs. 14-28). Coupons applied to 5.4% of claims through month 8, declining to 3.9% thereafter, with free trial use showing the sharpest drop. As coupon offsets waned, payer spending and patient OOP costs rose modestly (p < 0.001).
CONCLUSIONS: Manufacturer coupons for GLP-1 RAs are concentrated early in treatment and decline rapidly, suggesting these programs facilitate initiation rather than long-term adherence. After month 8, remaining drug costs increasingly shift to patients and payers.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HPR42
Topic
Health Policy & Regulatory
Topic Subcategory
Insurance Systems & National Health Care
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)