Data Brief: GLP-1 Prescriptions for Weight Loss over Time, 2018-2023

Introduction#

GLP-1 (Glucagon-like peptide-1) drugs have been around for many years but have recently grown in popularity. GLP-1s are injectable medications that work by increasing insulin production and delaying digestion to control hunger. For diabetic patients this therapeutic class helps control blood glucose levels and can be used in combination with other common diabetic drugs such as insulin and oral medication metformin. For obesity and weight loss patients, the delayed digestion and feeling of fullness promotes weight loss.¹

GLP-1s have been part of diabetic treatment plans since 2005. In 2014, the U.S. Food and Drug Administration approved the first GLP-1 for weight loss. GLP-1 use has been shown to lead to meaningful weight loss and to greatly reduce the likelihood of conditions and complications associated with obesity, such as cardiovascular disease, and some GLP-1s have also been associated with other desirable health outcomes, such as decreased risk of depression or anxiety. However, GLP-1 drugs are costly. Research on disparities in the use of GLP-1s has shown that these are linked to income, race, and ethnicity, raising concerns that high costs limit access to GLP-1s for certain vulnerable populations.^2,3,4,5

GLP-1 drugs illustrate the challenging tradeoffs inherent in healthcare access and cost. Utilization has increased dramatically for these drugs, which can add systemic cost pressures. With the enacted 2025–26 State Budget,  Medi-Cal no longer covers GLP-1 prescriptions for weight loss and weight loss-related uses as of January 1, 2026. Commercial health plan coverage of GLP-1s for weight loss remains inconsistent. Many commercial health plans and employer-sponsored benefit programs either exclude anti-obesity medications from formularies entirely or place them on higher cost-sharing tiers, resulting in limited or no insurance coverage for patients, even when clinically appropriate.⁶

This data brief examines trends in the prescription of five GLP-1 drugs for weight loss, compares total costs between Medi-Cal and commercial payers for each drug, and maps the average total yearly cost (paid cost + out-of-pocket cost) per member by county. Medicare is not included because the necessary data was not available at the time of this analysis.

The analyses for this report were conducted using data from California’s Healthcare Payments Data (HPD) Program. HPD is California’s All Payer Claims Database or APCD; it is a research database comprised of healthcare administrative data: claims and encounters generated by transactions among payers and providers on behalf of insured individuals. For additional information about the HPD Program, including details on data sources, populations included, and data elements available, see HPD Public Reporting FAQ, HPD Resources, and the HPD Snapshot (and its Technical Note).

The following visualizations present data from retail pharmaceutical claims paid by Medi-Cal or commercial plans. The total costs reported do not reflect rebates, coupons, or other discounts, as these are not reported to HCAI (see the Notes sections below for definitions and more details). Cost per member is based on the total (paid cost + out-of-pocket cost) divided by total number of members for each county. To increase the likelihood that all GLP-1 prescriptions were for weight loss, those that were prescribed to individuals with diabetes were removed.

Notes:

• This visualization displays fee-for-service (FFS) retail pharmaceutical costs (billed on a pharmacy claim) paid by an insurance plan only; medical pharmaceutical costs (billed on a medical/institutional claim), non-FFS (e.g., capitated) pharmaceutical costs, and non-covered drug products are not included in these numbers.
• The cost data does not reflect rebates, coupons, or other discounts, as these are not reported to HCAI.
• These amounts exclude prescriptions for individuals with diabetes.