The GLP-1 paradox: too expensive to cover, too effective to cut
Bryan Sivak, Elina Onitskansky
Thu, July 23, 2026 at 5:00 PM GMT+5:30
5 min read
The U.S. healthcare system is at a critical juncture with rising obesity and chronic disease coupled with skyrocketing GLP-1 costs. Three in four (76.4%) U.S. adults have at least one chronic condition, and over half (51.4%) have two or more
At the same time, spending on GLP-1 treatments has surged by more than 500% between 2019 and 2024. Growth is expected to continue, especially with the introduction of the Bridge program, which offers GLP-1 access for obesity with comorbidities under Medicare and Medicaid. Experts predict the number of people in the U.S. using GLP-1s could reach 25 million by 2030 (rising from 10 million in 2025)
While the health need is great, the near-term financial pressure feels unsustainable. Plans across government and employers are pulling back support. This month, MassHealth announced it would cease covering the medication, a move that will impact 22,000 Massachusetts residents but save the state an expected $15 million per year. Last month, Cigna became the latest organization to cease access for its employees. More may follow – research from the Business Group on Health found 10% of companies that now cover GLP-1s for weight-loss plan to drop them by 2027.
Too many states and employers are viewing this through a binary lens between those who want unfettered access and those that reject coverage. We need to get off this roller coaster, where access and affordability are pitted against each other, and move toward a financially sustainable treatment approach that actually enables progress on chronic disease. GLP-1s can make a significant dent in the obesity epidemic and reduce downstream costs of treating diabetes, chronic kidney disease, liver disease, musculoskeletal conditions, and more. The answer isn’t to reach for a hammer and eliminate GLP-1 coverage entirely. It’s to use a smart scalpel to target the right population at the right time with unique, data-driven care plans.”
Individualized treatment that moves beyond just GLPs
With so much of the U.S. facing metabolic disorder, the magnitude of the challenge – and the cost of treating it – can feel overwhelming
One of the problems we’ve had in treating obesity is the lack of data on it within our healthcare system. Obesity wasn’t considered a disease until a decade ago, meaning that most physicians are not trained in this area and it remains woefully underrepresented in claims data.
With the breakthrough of GLP-1s, doctors now have access to powerful medication but are still unequipped with the skills, experience, or infrastructure to prescribe them effectively. We have a treatment that can work, but neither the delivery system to support meaningful health outcomes nor the budget to cover it. We need to move away from binary decisions about medication access toward an individualized approach to treatment selection and support
