Almost every adherence number this desk sees comes from a trial that hands people the drug for free. This one did the opposite on purpose: participants were randomized to a prescription and then had to fill it through their own insurance, like anyone else [1]. The result is a rare measurement of the gap between being prescribed something and ending up on it — the gap this desk tracks from the other end in what prior authorization costs you.
Assigned one drug, 84% had filled it four months later. Assigned two, 53% had. By the end of a ten-month median follow-up the figures were 87% and 68%. So roughly a third of people told to start two medications had not started both, in a trial, with staff actively trying to help them.
Two limits matter. This is a feasibility phase with 173 participants, not the main trial, and it reports no clinical outcomes at all — the quality-of-life instruments showed no change over the period. And every participant was insured, so this is the friction that exists with coverage, not without it.
That second point is the one this desk keeps returning to. Insured people, in a trial, with support, filled a two-drug regimen barely half the time at four months. The self-pay buyers this desk serves face the same pharmacy and the same side effects without the insurance or the study coordinator — which is why the discontinuation question sits underneath every prepay decision in what six-month discontinuation does to a prepay.
This desk prices GLP-1 drugs and does not publish SGLT2 inhibitor prices, so there is no combination cost to quote here. What transfers is the shape: each additional medication in a regimen is another chance for the chain to break, at the pharmacy counter or a month later. Anyone weighing an annual plan should price the regimen they will actually be taking in month six, not the one on the intake form — the reasoning behind why flat-rate pricing costs nothing to advertise.