{
  "abstract": "Introduction\n\nAccess to GLP-1 receptor agonists (GLP-1 RAs) remains strongly shaped by payer coverage and utilization management. Patient-level evidence on GLP-1 RA denial across payer types is limited.Methods\n\nUsing a national multi-payer claims database capturing adjudication status of pharmacy claims, we examined GLP-1 RA prescription denial and whether individuals with an index denial subsequently obtained a paid fill from 2018 to 2024. The index claim was defined as each individual's first observed GLP-1 RA claim. We estimated multivariable logistic regressions to examine factors associated with index-claim denial and the likelihood of receiving a paid fill within 90 days among individuals with a denied index claim.Results\n\nOverall, 7.9% of individuals had a denied index GLP-1 RA claim, increasing from 4.0% (2018) to 9.6% (2022) before declining to 6.6% (2024). Denial was higher in Medicaid than in commercial coverage (12.6% vs 5.6%) and for obesity-indicated than diabetes-indicated brands (16.8% vs 6.3%). Among individuals with a denied index claim, 34.1% obtained a paid fill within 90 days, declining from 45.9% (2018) to 24.8% (2024).Conclusion\n\nDenial was concentrated in Medicaid and obesity-indicated products, and most individuals with a denied index claim did not obtain a paid fill within 90 days.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10022, USA.",
    "Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.",
    "Division of Healthcare Delivery Science & Innovation, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10022, USA.",
    "Cornell Health Policy Center, New York, NY 10065, USA."
  ],
  "article_type": "brief report",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Miaoqing Jia",
      "orcid": "0000-0001-6447-8714"
    },
    {
      "affs": [
        1
      ],
      "name": "Joseph F Levy",
      "orcid": "0000-0002-9317-5306"
    },
    {
      "affs": [
        0
      ],
      "name": "Emma E McGinty"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Sri Lekha Tummalapalli",
      "orcid": "0000-0002-6513-8460"
    },
    {
      "affs": [
        0
      ],
      "name": "Yongkang Zhang",
      "orcid": "0000-0001-6312-9686"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fh36x9r8sjvcb.bib",
  "cited_by": 0,
  "doi": "10.1093/haschl/qxag284",
  "fulltext_url": "https://europepmc.org/articles/PMC13711673",
  "id": "fh36x9r8sjvcb",
  "issns": [
    "2976-5390"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948647",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00862"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02360"
    ],
    [
      "heading",
      "Brief Report"
    ],
    [
      "heading",
      "haschl/pt_55"
    ],
    [
      "openalex",
      "2002|Pharmaceutical Economics and Policy"
    ]
  ],
  "openalex": "W7221931729",
  "pdf_url": "https://europepmc.org/articles/PMC13711673?pdf=render",
  "pmcid": "PMC13711673",
  "pmid": "42948647",
  "published": "2026-10-15",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/fh36x9r8sjvcb.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:34Z",
      "native_id": "MED:42948647",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948647"
    },
    {
      "first_seen": "2026-10-31T12:22:24Z",
      "native_id": "PMC13711673",
      "source": "pmc",
      "url": "https://doi.org/10.1093/haschl/qxag284"
    }
  ],
  "subjects": [],
  "title": "Prescription denials for GLP-1 receptor agonists across commercial, Medicare, and Medicaid coverage, 2018-2024.",
  "title_text": "Prescription denials for GLP-1 receptor agonists across commercial, Medicare, and Medicaid coverage, 2018-2024.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:24Z",
  "url": "https://research.draconitic.com/paper/fh36x9r8sjvcb",
  "venue": "Health affairs scholar",
  "versions": []
}