A national survey series tracked who was actually getting these drugs as they went from rare to common, using seven years of the Medical Expenditure Panel Survey [1]. Use rose roughly tenfold overall, from 0.42% to 4.45% of adults, and among adults with a condition the drugs are approved for it went from 8.50% to 31.36%. The prices that ran alongside that growth are the subject of what a GLP-1 actually costs.
Spending per prescription rose by nearly half across the same period, which is the detail that turns a growth story into an access story. When a drug gets both more popular and more expensive per fill, the question of who is left out stops being hypothetical, and this study answers it directly.
Against privately insured, higher-income, college-educated white adults as the reference, the odds of using one of these medications were lower for uninsured adults (OR 0.53, 95% CI 0.31–0.92), for adults with less than a high school education (OR 0.67, 95% CI 0.53–0.85), for middle-income and low-income earners (both OR 0.73), for Hispanic adults (OR 0.74, 95% CI 0.58–0.94) and for Black adults (OR 0.78, 95% CI 0.62–0.99). Every one of those intervals sits below parity.
One measurement caveat carries through everything above. The study reports GLP-1 drugs and SGLT2 inhibitors as a single utilization outcome, so none of these odds ratios is a GLP-1 figure on its own, and the two classes have different prices, different indications and different coverage rules. The direction is clear and the attribution to one class is not available.
For this desk the finding lands somewhere specific. Cash-pay telehealth exists largely because the insured route is closed or slow for a great many people, and a market where the uninsured have roughly half the odds of getting a drug through normal channels is the market these sellers are selling into. What coverage does to the price is examined in what insurance coverage costs, how rare employer coverage actually is in the nineteen percent with employer coverage, and what happens to a national bill when a country does cover it in does national coverage cost more.