The New GLP-1 Shortage: Insurance Coverage and Access
A year ago, we had these wonderful new obesity medicines – semaglutide and tirzepatide – and nobody could get them. Demand had outstripped supply and we had a shortage. Earlier this year, the supply shortage for both drugs resolved, but now we face the same situation because of a different shortage. There is a shortage of health insurance plans that provide coverage for GLP-1 medicines. The reasons are different, but the outcome is the same.
Many of the people with a real medical need for these medicines simply cannot get them. Or they resort to chasing compounded products of uncertain quality for which they can afford to pay cash.
A Revolution Stalling?
This situation leads Nicholas Florko to write in The Atlantic that “the the obesity-drug revolution is stalling.” He concludes this because, even after the end of the shortage, it seems “harder than ever” to get these medicines. These are medicines that are personally important to him and yet his reporting on this situation is remarkably dispassionate and thorough:
“For all the hype over GLP-1s, Americans have struggled to access these weekly injections. Seniors can’t get these drugs because Medicare is barred by law from covering them for obesity. Drugmakers previously couldn’t make enough of the drugs to keep up with demand, prompting the FDA to formally declare a shortage. The supply issues have now abated, but getting these drugs has somehow become even harder. The problem is that insurance companies are refusing to cover them.”
This is a complex problem that grows out of serious issues with both American healthcare systems and global funding and pricing for the products of pharmaceutical research. Simple finger-pointing doesn’t work.
But one thing is clear. Healthcare systems are clearly not working to address the most prevalent and serious chronic disease we face.
Human Challenges
This problem manifests in many ways. It promotes even wider health disparities because people of modest means cannot get access to these medicines. They go to wealthy and privileged persons first. But it is the people of modest means who often need them most.
Even people with comfortable incomes face challenges, though. We spoke last week with a CEO from a nonprofit organization who can only get a GLP-1 if she goes to an online source for a compounded version. She’s smart and well-informed. She sees her sister doing well on a GLP-1, but between the weight bias she faces from traditional providers and the refusal of her health insurance to cover this, it has become impossible for her to gain access to the medicine she needs any other way. And this is working for her. Her health and quality of life are better than ever – even as she worries a bit about the reliability of a compounded GLP-1.
Yes, the supply shortage is over. Now we face a shortage of insurance coverage and access to GLP-1 medicines. The more things change, the more they stay the same.
Click here for free access to Florko’s essay in The Atlantic and here for a business perspective on what lies ahead in this marketplace.
Broken Eggs, painting by Jean-Baptiste Greuze, photographed by David Monniaux, and licensed under CC BY-SA 4.0
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November 3, 2025
