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BACKGROUND <p>Glucagon-like peptide-1 (GLP-1) receptor agonists are increasingly used for glycemic control, chronic weight management, and cardiovascular risk reduction. There is growing interest in understanding GLP-1 spending and affordability patterns.</p> OBJECTIVE <p>To evaluate national trends in total and out-of-pocket (OOP) spending on GLP-1&#xa0;s and other incretin mimetics.</p> DESIGN <p>Cross-sectional study.</p> PARTICIPANTS <p>U.S. adults (aged ≥ 18&#xa0;years) in the 2013–2023 Medical Expenditure Panel Survey (MEPS).</p> MAIN MEASURES <p>We included four measures: (1) total annual GLP-1 spending; (2) median annual GLP-1 OOP spending per individual; (3) OOP burden, defined as an individual’s annual GLP-1 OOP spending as a share of their household income; and (4) high OOP burden, defined as the proportion of GLP-1 users with OOP burden ≥ 10%.</p> KEY RESULTS <p>The analytic sample comprised 2,797 survey respondents, representing 33 million adults nationally; approximately 99% of these respondents were identified directly from medication names and the other 1% was identified using the MEPS code for other GLP-1&#xa0;s/other incretin mimetics. Total GLP-1 spending increased nearly 15-fold, from $4.4 billion in 2013 to $64.9 billion in 2023, reflecting an average annual percentage change of 31.02% (95% CI, 27.6%–34.5%; <i>P</i> &lt; .001). Median annual per-capita OOP spending was $1,528 and highest among privately insured patients and high-income adults. Mean OOP burden was 7.04% and highest among uninsured, publicly insured, and low-income adults. On average, nearly one in five (18.18%) GLP-1 users experienced high OOP burden, which was also highest among uninsured, publicly insured, and low-income adults.</p> CONCLUSIONS <p>Spending on GLP-1&#xa0;s and other incretin mimetics rose substantially over time, emphasizing the need to ensure the affordability of these key therapies, particularly among uninsured and lower-income populations.</p>

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Spending and Affordability of Glucagon-Like Peptide-1 Receptor Agonists and Other Incretin Mimetics in the United States, 2013–2023

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月30日

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  • David T. Zhu,
  • Chloe Gao,
  • Ye In Christopher Kwon,
  • Alan Lai

摘要

BACKGROUND

Glucagon-like peptide-1 (GLP-1) receptor agonists are increasingly used for glycemic control, chronic weight management, and cardiovascular risk reduction. There is growing interest in understanding GLP-1 spending and affordability patterns.

OBJECTIVE

To evaluate national trends in total and out-of-pocket (OOP) spending on GLP-1 s and other incretin mimetics.

DESIGN

Cross-sectional study.

PARTICIPANTS

U.S. adults (aged ≥ 18 years) in the 2013–2023 Medical Expenditure Panel Survey (MEPS).

MAIN MEASURES

We included four measures: (1) total annual GLP-1 spending; (2) median annual GLP-1 OOP spending per individual; (3) OOP burden, defined as an individual’s annual GLP-1 OOP spending as a share of their household income; and (4) high OOP burden, defined as the proportion of GLP-1 users with OOP burden ≥ 10%.

KEY RESULTS

The analytic sample comprised 2,797 survey respondents, representing 33 million adults nationally; approximately 99% of these respondents were identified directly from medication names and the other 1% was identified using the MEPS code for other GLP-1 s/other incretin mimetics. Total GLP-1 spending increased nearly 15-fold, from $4.4 billion in 2013 to $64.9 billion in 2023, reflecting an average annual percentage change of 31.02% (95% CI, 27.6%–34.5%; P < .001). Median annual per-capita OOP spending was $1,528 and highest among privately insured patients and high-income adults. Mean OOP burden was 7.04% and highest among uninsured, publicly insured, and low-income adults. On average, nearly one in five (18.18%) GLP-1 users experienced high OOP burden, which was also highest among uninsured, publicly insured, and low-income adults.

CONCLUSIONS

Spending on GLP-1 s and other incretin mimetics rose substantially over time, emphasizing the need to ensure the affordability of these key therapies, particularly among uninsured and lower-income populations.