2025 Pharmacy in Focus Report
Navigating the GLP-1 conundrum: Demand, cost, and sustainability
Expanding drug implications are driving historic change
Today’s health landscape is changing fast. The pharmaceutical industry is one of the most visible and influential faces of that shift. Expanded therapeutic options are providing more and more patients with relief from chronic conditions, but innovation comes at a cost.
In the 2025 Pharmacy in Focus report by the Evernorth Research Institute, we examine the state of pharmaceuticals through the lens of one of the most influential therapies. Glucagon-like peptide-1 receptor agonists (GLP-1s) is an expanding drug class with increased demand with increased demand that is driving historic shift in drug trends.
Key insights
Key insights
GLP-1s drive a historic shift in traditional drug spending increases, outpacing specialty drug trends for the first time.
GLP-1s face dual challenges of rapid uptake and high discontinuation rates, raising questions about long-term value.
Surging GLP-1 use among youths amplifies sustainability and supply concerns.
Explore the full story on GLP-1s and their role in reshaping the pharmaceutical landscape
GLP-1s lead a historic shift — as traditional drug costs outpace specialty drugs
Traditional drugs, commonly used to treat everyday conditions such as high blood pressure, infections, and diabetes and have historically maintained stable costs due to generic drug expansion and industry-led cost-control methods. The approval of Wegovy for chronic weight management in 2021 saw traditional drug spending surge.
For the first time, traditional drug spending surpassed specialty drug spending
Pharmacy spending is expected to rise
The market for GLP-1s continues to grow and the medicalization of weight loss continues to rise—further straining tight health care budgets.
46.8%
Weight loss therapy contribution to drug-spend increase.
73.1%
Projected increase in GLP-1 utilization for weight loss by the end of the year.
Unexpected population trends raise sustainability and disparity concerns
Although GLP-1s are known to be effective in managing type 2 diabetes, the rapid rise of GLP-1s in recent years has been largely driven by its weight loss benefits. Employers and health plans navigate the financial and logistical challenges of GLP-1 coverage. Employers and health plans are having to navigate the financial and logistical challenges of GLP-1 coverage.
Rapid uptake and high discontinuation rates raise questions about the long-term value of GLP-1s
The widespread adoption of GLP-1s for weight loss has been incredibly rapid in the last two years. However, despite the high demand, data shows many patients who begin GLP-1 weight loss treatment do not finish their course of treatment.
GLP-1 usage has surged, but many stop treatment prematurely
While high costs may play a role in discontinuation, cases where side effects prompt patients to stop treatment should raise concerns for plan sponsors about the significant upfront investment required to initiate these therapies.
Popularity of GLP-1s among younger generations amplifies sustainability concerns
GLP-1 use increased dramatically among younger generations – likely reflecting the recent approval of the drug for children 12 and older. Heightened body image pressures for youth and greater social acceptance of weight loss pharmaceuticals may also be at play.
Surging youth adoption brings cost concerns
If an ever-growing number of patients adopt GLP-1s early and rely on them for life, the burden of cost could prove unsustainable for health plans and employers. Holistic, community-level approaches are needed now more than ever to proactively address youth obesity.
GLP-1 expansion implications
In addition to weight loss, GLP-1s are also being evaluated to treat common conditions such as cardiovascular disease, chronic kidney disease, Alzheimer’s disease, and even sleep apnea. Employers and health plans must closely monitor GLP-1 usage to ensure proper utilization, address cost management and monitor the effects expanding indications may have on their coverage policies.
Learn more about how GLP-1s are reshaping the pharmaceutical landscape
Sources
- Do D, Lee T, Peasah SK, Good CB, Inneh A, Patel U. GLP-1 Receptor Agonist Discontinuation Among Patients with Obesity and/or Type 2 Diabetes. JAMA Netw Open. 2024;7(5):e2413172. doi:10.1001/jamanetworkopen.2024.13172
- GLP-1s only approved for children 12 and older