Expert: How Pharmacists Can Improve Access and Affordability of GLP-1 Therapies

In an interview with Pharmacy Times, Ferrin Williams, PharmD, MBA, chief pharmacy officer at Scripta Insights, discussed practical strategies pharmacists can use to help patients navigate access, affordability, and appropriate use of glucagon-like peptide-1 (GLP-1) receptor agonists, including emerging oral options, amid ongoing coverage variability and cost barriers.

“My goal is to help you pay the lowest, safe price—but first we have to confirm what your plan will actually cover and what documentation it requires.” - Ferrin Williams, PharmD, MBA

Williams emphasized that pharmacists should first determine whether a patient has insurance coverage, as strategies differ significantly between covered and cash-pay pathways. For insured patients, she stressed the importance of confirming the billed indication, noting that many plans more consistently cover GLP-1s for diabetes than for obesity. Accurate documentation—such as diagnosis codes, body mass index, comorbidities, and prior weight-loss attempts—can meaningfully affect coverage decisions. Williams encouraged pharmacists to “work the formulary like a playbook,” reviewing preferred agents, step therapy requirements, quantity limits, and pharmacy network rules that may substantially lower patient out-of-pocket costs.

Prior authorization support was identified as another critical pharmacist role. Williams noted that incomplete submissions remain a leading cause of denials and delays and that pharmacists can assist prescribers by providing clear checklists of required clinical information. She also highlighted the need to proactively assess deductible status and accumulator rules early in the plan year, setting realistic patient expectations regarding initial fill costs.

For patients without coverage or facing unaffordable copays, Williams outlined cash-pay considerations, including transparent pricing comparisons, appropriate screening for manufacturer assistance programs, and discussion of clinically appropriate therapeutic alternatives. She cautioned pharmacists to approach compounded products ethically, ensuring patients understand quality variability and sourcing considerations.

Finally, Williams addressed medication switching, noting that GLP-1 transitions should often be treated as new starts. Conservative titration, avoidance of dosing gaps or overlap, careful monitoring for gastrointestinal effects, and coordination with prescribers around hypoglycemia risk are essential. Overall, Williams underscored pharmacists’ central role in aligning clinical appropriateness with cost-effective access.