Due to their incredible popularity, GLP-1s have faced unique issues when it comes to getting the medication in the hands of the patients who need it. Ferrin Williams, PharmD, spoke with Pharmaceutical Executive about these issues and how they’re impacting the market.

What unique issues are impacting GLP-1s?

Pharmaceutical Executive: What are the factors that are impacting the compounded semaglutide market?
Ferrin Williams, PharmD: Several key factors are impacting the compounded semaglutide market:

• FDA Enforcement: Recent FDA action has restricted the ability of compounding pharmacies to dispense semaglutide.
• Patent Protections: Novo Nordisk’s intellectual property limits legal compounding of semaglutide salts, and they’ve issued cease-and-desist letters to many telehealth and compounding providers.
• Safety & Quality Concerns: Without consistent oversight, compounded versions may have variable potency or contain different salt forms not found in FDA-approved products. This has raised concerns from providers and payers.
• Demand vs. Supply Gap: Even as access to compounded semaglutide contracts, demand continues to rise—keeping pressure on affordability and access.

PE: Are insurance providers covering Wegovy, and for what conditions?
Williams: Coverage for Wegovy varies widely by plan. Generally:

• Although many industry reports have shown less than 20% of companies cover GLP-1s for weight loss, “49% of Scripta employer clients have coverage for Wegovy” Many are covering Wegovy only for patients with a BMI ≥30, or ≥27 with established cardiovascular disease.
• Employer-sponsored plans may opt in or out of GLP-1 coverage for weight loss through their Pharmacy Benefit Manager. Many have excluded it due to cost.
• Prior authorization is often required, and coverage is usually limited to weight management, not type 2 diabetes (which is covered under Ozempic or Mounjaro). That said, Scripta’s P&T Committee physicians note that the difficulty of obtaining prior authorization approvals for patients varies widely.

At Scripta, we’re seeing more employers reevaluate both on-plan and off-plan coverage options in response to growing member demand.

PE: How much is the demand for semaglutide expected to grow in the coming years?
Williams: Demand for semaglutide and other GLP-1s is expected to grow exponentially over the next 3–5 years:

• Estimates project the global obesity drug market will exceed $100B by 2030, with GLP-1s leading the charge.
• Public awareness and media attention (e.g., celebrity use, TikTok trends) have driven significant off-label interest.
• New indications for cardiovascular risk reduction, addiction treatment and many other indications further expand demand.
• Employer and insurer coverage decisions will be pivotal in shaping how quickly and equitably access grows. How much more do we all want our healthcare premiums to increase, and what value is it creating for the health of our families and fellow employees?

As clinical pharmacists and physicians at Scripta, we’re tracking not only the science—but also the evolving affordability and access challenges our clients face.