GLP-1 receptor agonists have emerged as a revolutionary force in medicine, changing how physicians approach weight management and diabetes care. Their proven efficacy has created unprecedented demand, yet a significant hurdle stands between these transformative treatments and the patients who need them: accessibility. This tension between what’s possible medically and what’s practical financially has created a complex power struggle. So, who is truly steering the ship when it comes to GLP-1 prescribing— the physicians on the front lines or the pharmacy benefit managers (PBMs) behind the scenes?
Our latest report, Who’s in control of GLP-1 prescribing — doctors or PBMs?, dives deep into this critical question. We explore the intricate dynamics shaping the prescribing landscape for these powerful medications. By combining robust data with real-world physician experiences, this report uncovers the pressures, challenges, and compromises that define the current state of GLP-1 access. It’s a look into a healthcare tug-of-war where patient outcomes hang in the balance.
Sermo unites real-world data and real physician voices
To deliver a comprehensive view of the GLP-1 landscape, Sermo combines two unmatched data sources: its global physician drug ratings database and first-party insights from its verified medical community.
We analyzed ratings from more than 1,100 physicians who evaluated Ozempic, Mounjaro, Wegovy, and Zepbound on Sermo’s platform, alongside survey feedback from over 300 active GLP-1 prescribers—including PCPs, endocrinologists, cardiologists, gastroenterologists, and pulmonologists. Together, these data sets reveal the real-world challenges physicians face when prescribing these drugs, from patient access barriers to PBM-driven coverage decisions—offering a uniquely validated view of how policy and practice intersect in modern medicine.
A glimpse into the findings: efficacy vs. access
The insights from our research are striking. Physicians are overwhelmingly confident in the clinical benefits of GLP-1 agonists. Their effectiveness in managing blood sugar and promoting weight loss is not in question, yet a nearly 40% gap separates how doctors rate GLP-1 efficacy from their accessibility—underscoring a deep disconnect between what a drug can do and whether patients can actually get it. This confidence in efficacy is frequently overshadowed by the practical challenges of getting these drugs to their patients.
One of the most revealing statistics from our report highlights this conflict directly. A staggering 73% of physicians surveyed have been forced to reduce or completely stop a patient’s GLP-1 therapy due to cost and insurance coverage issues, representing countless patients who started a life-changing treatment only to have it pulled away for reasons outside of their or their doctor’s control. It’s a moment of clinical whiplash that can leave patients feeling defeated and physicians feeling powerless.
Furthermore, the data shows that PBMs and insurance formularies are increasingly dictating the course of treatment. Access challenges are so pervasive that 51% of doctors say pharmacy coverage strongly influences their prescribing decisions. Many physicians report spending significant time on prior authorizations and appeals, battling a complex system just to get their patients the care they deem most appropriate. The struggle is so pronounced that it raises a fundamental question about clinical autonomy. When a physician’s prescription is consistently overridden by a PBM, who is truly managing the patient’s health?
Discover the full story
The tension between medical judgment and administrative gatekeeping is a defining challenge in modern healthcare, and the GLP-1 story is its most prominent chapter. Our report details the full extent of this struggle, offering a comprehensive look at the data, the physician perspectives, and the implications for the future of patient care.
What other barriers are physicians facing? How are patients responding when their treatment is disrupted? And what are the long-term consequences of PBMs holding the reins on these transformative therapies?
The results mentioned here are just the tip of the iceberg. To get a complete understanding of this complex issue and access all the key findings, download the full report. Uncover the data, hear from your peers, and arm yourself with the knowledge to navigate this evolving landscape.
