GLP-1 Receptor Agonist Use and Payments Surged in US Medicare Part D, Driven by Off-Label Prescribing

Glucagon-Like Peptide-1 receptor agonists (GLP-1 RAs) are highly effective for type 2 diabetes and obesity, but their high cost and insurance coverage limitations have led to a rise in off-label use and a market for compounded versions. Understanding the true scope of GLP-1 RA prescribing patterns, especially off-label use in populations without diabetes, is crucial for healthcare policy and resource allocation. This study addresses the gap in systematic data on GLP-1 RA utilization and payment trends within the US Medicare Part D system.

This nationally representative repeated cross-sectional study analyzed trends in glucagon-like peptide-1 receptor agonist (GLP-1 RA) usage and associated payments within the US Medicare Part D program from 2017 to 2022. The study included Medicare Part D beneficiaries who initiated GLP-1 RAs. The primary objective was to assess the extent of off-label GLP-1 RA prescribing among individuals without a diabetes diagnosis. Data were collected and analyzed to identify patterns in utilization and expenditures over the five-year period.