Striking Growth of GLP-1s in Women with PCOS
Truveta this week published data that reveals striking growth in the use of GLP-1s by women with PCOS (polycystic ovary syndrome). Prescriptions for semaglutide or tirzepatide have risen by more than 700% in women with PCOS, according to their analysis.
So don’t think that this is slipping right by the bean counters at drug benefit plans. In fact, denials for coverage of these medicines specifically for women with a PCOS diagnosis is common, says Tahira Adaya, who herself has been living with a PCOS diagnosis for decades. She has to pay cash out of pocket for tirzepatide and recently told USA Today:
“I’m hoping the insurance policy will change soon, but I’m glad to have that on my record now. It feels like 1 in 10 women having PCOS should be enough to move the needle on what gets covered with insurance, but it is a messy system.”
Messy indeed.
No, It’s Not a Miracle
It gets messy for two reasons. First of all, PBMs have a hand in determining what gets covered and the have a penchant for making the process a pain. Especially when GLP-1s are involved. PBMs seem to be on a seek and destroy mission right now when it comes to GLP-1 use.
But second, there is the challenge of managing PCOS. It is a complicated condition that does not yield to cookbook medicine. What works for one person – perhaps very well – will by no means work for everyone. Both semaglutide and tirzepatide can be quite helpful for some patients and not at all for others. Thus, neither of these drugs have an indication specifically for PCOS. And that gives payers an excuse to deny coverage.
Internal medicine physician and women’s health advocate Jennifer Peña explains the need for personalized medicine in PCOS:
“You cannot say the GLPs are going to fix the entire problem, because PCOS is not a one-size-fits-all type of condition. GLP-1s have an important role, but we have to be thoughtful about how we’re going to use it and personalize it to the patient.”
Unfortunately, payers will exploit this to make it hard for women with PCOS to get the care they need, especially if it involves GLP-1s. It seems that having a medicine that works is not the end of the story in our messy healthcare systems.
Click here and here for more on the rise of GLP-1s in women with PCOS. For more on the frustration with insurance coverage for this, click here. For a meta-analysis of data on GLP-1s in women with PCOS, click here.
Woman on the Bedside, painting by Rik Wouters / WikiArt
Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.
December 14, 2025
