Mapping the True Cost of Breakthrough Therapies

Editorial Note: Maggie’s article first appeared on Health IT Answers. The full article is linked below.

How Data Can Close the GLP-1 Access Gap

Breakthrough therapies like GLP-1 medications—Ozempic, Wegovy, and Rybelsus—have reshaped how we approach chronic conditions like diabetes and obesity. Yet, their benefits remain out of reach for millions. With annual price tags hovering around $12,000 and prescription rates skyrocketing by over 400% between 2019 and 2023, the affordability and accessibility challenge is undeniable. According to a recent KFF poll, more than half of adults prescribed GLP-1 drugs struggle to afford them—even 53% of those with insurance coverage report significant difficulty.

While national drug pricing negotiations, including Medicare’s efforts, are a step forward, they only address part of the issue. Ensuring equitable access requires a closer look, not just at the list price but at the complex, local realities shaping who can and can’t afford these medications. That’s where data and technology come in.

Beyond National Averages: Why Localized Data Matters

Broad statistics can highlight growing prescription trends and overall spending—Medicare’s $5.7 billion spend on three GLP-1s in 2022 speaks volumes—but they don’t reveal the nuances driving access disparities. Neighborhoods with similar obesity or diabetes rates may face very different barriers, depending on factors like income levels, insurance coverage, pharmacy access, and healthcare infrastructure.