GLP-1 receptor agonists have become a cornerstone in managing type 2 diabetes and obesity, offering significant benefits in glycemic control and weight loss. However, a recent study published in JAMA reveals a concerning trend: 53.6% of adults prescribed a GLP-1 receptor agonist discontinued therapy within one year, and 72.2% stopped within two years.¹ This high discontinuation rate highlights the need for effective strategies to support patients selecting the appropriate medication and providing continuous monitoring to prevent early discontinuation. Pharmacists, with their specialized knowledge and patient-centered approach, are uniquely positioned to reduce these discontinuation rates.
GLP-1s: A Game-Changer for Diabetes Management
GLP-1 receptor agonists work by mimicking the action of the glucagon-like peptide-1 hormone, which helps regulate blood sugar levels and appetite. These medications have been shown to improve glycemic control, promote weight loss, and reduce the risk of cardiovascular events in patients with type 2 diabetes.
While much of the focus has been on the use of GLP-1s for obesity and the associated healthcare costs, it's important to remember that these medications are also widely accessible and popular among patients with diabetes. In fact, about 1 in 5 US adults with type 2 diabetes were using GLP-1 receptor agonists by 2022.² Despite their benefits, patients with diabetes face the same challenges with GLP-1s, including side effects such as nausea and vomiting, high medication costs, and issues related to adherence, leading to similar discontinuation rates.
Unpacking the Study: What the Numbers Reveal
The study published in JAMA aimed to investigate the discontinuation rates of GLP-1 receptor agonists among adults. Researchers analyzed a large sample of patients over a two-year period, tracking their adherence to the prescribed therapy. The findings were striking: more than half of the patients discontinued their therapy within the first year, and nearly three-quarters did so by the end of the second year. Factors contributing to these high discontinuation rates included side effects, availability, cost, and lack of patient education and support.¹
Sample Size and Demographics: The study included a diverse group of over 125 474 adults from various backgrounds.
Side Effects Leading to Discontinuation: Approximately 20% of patients reported side effects severe enough to consider stopping the medication.
Cost Leads to Discontinuation: Lower income was associated with higher discontinuation rates. Adverse effects and costs were the most frequently mentioned reasons for discontinuation.
The Financial Impact on Employers
The rising use of GLP-1 receptor agonists, such as Ozempic and Wegovy, is significantly impacting employer healthcare budgets. These medications, while effective for managing type 2 diabetes and obesity, come with high costs that can strain employer-sponsored health plans. For instance, the annual cost of GLP-1 medications can exceed $10,000 per employee.³ As more employees seek these treatments, employers face increasing financial pressure to cover these expenses. Some employers are implementing strategies like prior authorization and higher cost-sharing requirements to manage these costs.⁴ Employers face a growing challenge in balancing the benefits of improved employee health with the financial burden of these medications, especially given the high discontinuation rates.
Pharmacists: The Unsung Heroes in Patient Support
Pharmacists are uniquely equipped to support patients on GLP-1 therapy through comprehensive medication counseling and education. They can help patients understand the benefits and potential side effects of their medication, manage expectations, find patient assistance coupons, identify cost-effective alternatives, and offer practical advice on lifestyle modifications. Pharmacists also play a crucial role in monitoring patients for adverse effects, addressing concerns promptly, and offering solutions to improve adherence. By building strong relationships with patients, pharmacists can help overcome barriers to continued use of GLP-1 receptor agonists, ultimately reducing discontinuation rates.
Pharmacists Improve Medication Adherence: Research indicates that pharmacist-led interventions can improve medication adherence by up to 30%.⁴
Pharmacists Can Track and Educate on Drug Reactions: Many pharmacists have specialized training in diabetes management and medication therapy management, making them well-suited to support patients on GLP-1 therapy.⁵
Conclusion
The high discontinuation rates of GLP-1 receptor agonists highlighted in the recent study are a significant concern for the management of type 2 diabetes and obesity. Pharmacists, with their specialized knowledge and patient-centered approach, are essential in addressing this issue. By providing education, support, and personalized care, pharmacists can help patients maintain their therapy and achieve better health outcomes. Healthcare systems should recognize and leverage the critical role of pharmacists in managing GLP-1 therapy to ensure patients receive the full benefits of their treatment.⁶
References
JAMA Network Open. (2025). High discontinuation rates of GLP-1 agonists found among patients with obesity. JAMA Network Open, 8(1), e2457349. https://doi.org/10.1001/jamanetworkopen.2024.57349
Utilization Rates of SGLT2 Inhibitors and GLP-1 Receptor Agonists and Their Facility-Level Variation Among Patients With Atherosclerotic Cardiovascular Disease and Type 2 Diabetes. (2022). Journal of Diabetes Research. https://doi.org/10.2337/dc21-1815
WTW. (2024). GLP-1 Drugs: Implications for Employer Health Plans. Retrieved from https://www.wtwco.com/en-us/insights/2024/02/glp-1-drugs-implications-for-employer-health-plans
Healthcare Business Today. (2024). Employers' Dilemma: Weight Loss Drugs Coverage. Retrieved from https://www.healthcarebusinesstoday.com/employers-dilemma-weight-loss-drugs-coverage/#google_vignette
Pharmacy Focus: GLP-1 Medications and Pharmacists' Role in Counseling Patients. (2024). Pharmacy Times. Retrieved from https://www.pharmacytimes.com/view/pharmacy-focus-glp-1-medications-and-pharmacists-role-in-counseling-patients
Clinicians, Pharmacists Should Work to Ensure Safety Compounded GLP-1 Medications. (2024). American Pharmacists Association. Retrieved from https://www.pharmacytimes.com/view/clinicians-pharmacists-should-work-to-ensure-safety-compounded-glp-1-medications
Q&A: Pharmacists Play Pivotal Role in Evolving Diabetes Care with New Treatments. (2024). Diabetes Care Journal. Retrieved from https://www.pharmacytimes.com/view/q-a-pharmacists-play-pivotal-role-in-evolving-diabetes-care-with-new-treatments