Affordability isn’t a binary problem. Often, it’s viewed as a case of: Patients can get the medication, or they can’t. But in reality, access problems are much more nuanced, and patients do better when clinicians plan for those barriers early.
Access planning is part of prescribing
Patients won’t always bring up the issue of cost on their own. So it’s important to have the cost conversation early in the process of prescribing a GLP-1, not just when there is a problem or insurance denial. In doing so, it’s critical to identify whether a patient will continue to have access to the medication, and will be able to afford it over many months. This will play a big role in patient success.
Coverage and coupons may be temporary, but these medications are a long-term commitment.
Prescribe with sustainability in mind
Clinicians know that insurance formularies are not written in stone. So it’s important to explain to patients that just because a GLP-1 might be covered now, that doesn’t mean it will be covered in the future. Patients too might change their health insurance plan, and that could change their access. Addressing these changes in access before they happen can make the difference in a patient maintaining treatment.
The most vulnerable point for any patient can be when they lose access after early success.
Plan for interruptions before they happen
GLP-1 medications are a long-term commitment, but there may be times when a patient may want or need to stop them temporarily. Make sure your patient knows it’s always best to stop a GLP-1 under your guidance, and that they shouldn’t stop it suddenly on their own.
In these times, it’s key to have strategies for bridging treatment during this time. It’s also important to check in with patients to help them navigate it smoothly.
Affordability can get in the way of access. But it doesn't have to be the end of treatment, and it shouldn’t have to get in the way of a patient’s ultimate success.
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