Glucagon-like peptide-1 receptor agonists (GLP-1) therapies are transforming care by offering new hope in managing persistent chronic health conditions such as diabetes, heart disease, obesity, and sleep apnea. At the same time, the high costs and growing demand for these medications are raising concerns about affordability, sustainability, and equitable access.
To help our partners better understand how to navigate these challenges, The 2025 Pharmacy in Focus report tackles these issues and explores solutions. “From understanding how these therapies work to exploring their financial implications, this report aims to spark thoughtful conversation and drive meaningful action,” said Urvashi Patel, Ph.D., vice president of the Evernorth Research Institute, which produced the report.“Together, we can foster partnerships, streamline solutions, and deliver care that is accessible, sustainable, and effective.”
The report is based on a comprehensive nationwide survey of consumers with employer-sponsored health benefits, employers, providers, pharmacists, and health plan leaders, along with an extensive analysis of claims data from 28 million commercially insured individuals and an evaluation of industry and scientific literature.
Our research identified the following three key insights and strategic actions to address these concerns in 2025 and beyond.
1. GLP-1s drive a historic shift in traditional drug spending increases, outpacing specialty drug trends for the first time.
Drugs targeting weight management accounted for about half of the total increase in drug spend in 2024. GLP-1s for weight loss were the predominant driver, equating to 6.7% of total drug costs.
GLP-1 therapies are poised for continued growth, with 24% of consumers currently considering GLP-1s and 65% of providers willing to prescribe them. This will likely fuel the upward trend, with a projected 73.1% increase in utilization for weight loss in 2025.
While GLP-1 weight loss therapies are driving significant growth in drug trend, their increasing use in diabetes management further solidifies their prominence in the health care landscape. We saw a notable decline in the use of traditional, lower-cost diabetes therapies such as metformin and insulin and a significant rise in the adoption of newer, high-cost therapies such as GLP-1s.
As GLP-1 demand and utilization expand, providing comprehensive clinical support and cost-management strategies are crucial for keeping pharmaceutical innovation accessible to patients while safeguarding health care budgets. Key strategies include implementing lifestyle interventions, optimizing formularies, and choosing capable, clinically focused partners to ensure sustainable and patient-centered outcomes.
2. GLP-1s face dual challenges of rapid uptake and high discontinuation rates, raising questions about long-term value
Establishing clear eligibility guidelines and specific requirements when prescribing GLP-1s for weight loss are important to ensure long-term value. Discontinuing GLP-1 therapy – even for the short term – has a significant influence on clinical outcomes and drug trends. Our research shows that more than 50% of patients using GLP-1s for weight loss stopped their treatment within 12 months. Concerns about side effects and medication safety were the main reason for discontinuation, cited by almost half of the patients who stopped utilizing GLP-1s. Another 4 out of 10 patients said they no longer needed the medication, while less than a third cited financial and insurance barriers.
Strategies that support appropriate use, incorporate timely clinical information, and utilize nondrug interventions are essential to optimizing patient management while ensuring positive clinical outcomes and economic sustainability. For example, identifying patients most likely to benefit from GLP-1s based on clinical profiles, metabolic markers, and adherence potential helps reduce discontinuation, maximize benefits, and avoid inappropriate prescribing, while using digital tools or mobile health apps can help track the severity of side effects and prompt early intervention. In addition, pharmacists play a critical role in optimizing GLP-1 therapies by supporting patients with education, safe use, and adherence strategies.
3. Surging GLP-1 use among youths amplifies sustainability and supply concerns
GLP-1 prescriptions for weight loss are growing fastest in younger generations, with the highest percent of increase from 2023 to 2024 among members of Gen Alpha (children 14 and younger), who had an 84.6% jump in utilization, and Gen Z (15 to 28), whose utilization increased by 67.8%. The FDA’s first approval of a GLP-1 for weight loss in adolescents came in December 2022.
Although GLP-1s can be an effective component of a comprehensive weight management strategy for adolescents, the American Academy of Pediatrics emphasizes that pharmacological treatments should be considered within a broader context that includes lifestyle modifications and behavioral interventions. Lifestyle interventions such as increasing physical activity, improving diet, and reducing screen time, alongside community- and system-level initiatives, could help reverse this trend and possibly eliminate the need for medications.
Reshaping the pharmaceutical landscape for a sustainable future
As the U.S. obesity epidemic continues to grow, GLP-1s are expected to place additional financial strains on health plans and employers. In addition, high discontinuation rates could have significant long-term value implications.
The challenges and positive aspects outlined in our research on GLP-1 utilization require an empathetic and comprehensive approach. The landscape demands partnering in new and unconventional ways to ensure a well-functioning, patient-centered, equitable health care system.
