Prescribing data answers a question that marketing copy never will, which is what is actually happening rather than what a seller says should happen. A retrospective cohort tracked semaglutide and tirzepatide prescriptions in the year either side of delivery across the United States from 2019 to 2024 [1]. It belongs beside the access picture in who the price filtered out, which tracks the same expansion from a different angle.
In the year before delivery, prescribing went from 0.2 to 6.4 per 1,000 deliveries. In the year after, from 0.3 to 14.6 per 1,000, which is about one and a half percent of all deliveries. Segmented regression with change-point detection placed the acceleration at June 2022 for the predelivery window and March 2021 for the postdelivery one.
One measurement detail changes what the predelivery number means. The window is the whole year before delivery, which includes months before anyone knew a pregnancy existed. A prescription filled in that period is not evidence of a clinician knowingly prescribing to a pregnant patient, and part of the rise simply reflects more people of reproductive age taking these drugs at all. The postdelivery figure has no such ambiguity, and it is the larger of the two.
For anyone buying through a telehealth seller, the practical question is what the intake form asks and what it does with the answer. Pregnancy screening is one of the places where the thoroughness of an intake varies most between sellers, and this desk has found wide variation in what sellers disclose and verify generally — the pattern is set out in sellers publishing two different prices and in what the secret-shopper study found. A drug whose perinatal safety data is explicitly described as insufficient by the people counting the prescriptions is one where that screening matters more than usual, and anyone pregnant, nursing or planning a pregnancy needs an obstetrician in the conversation rather than a web form. What coverage has to do with any of it is a separate question handled in what insurance coverage costs.