A survey of primary care physicians' views on supporting patients who lose insurance coverage for Glucagon-Like Peptide-1-based drugs for weight management.

BACKGROUND

Glucagon-like peptide-1 (GLP-1)-based drugs for weight management are commonly prescribed by primary care physicians (PCPs), many of whom have limited familiarity with alternative weight management treatments. This knowledge gap may be especially problematic when patients lose insurance coverage for - and therefore access to - GLP-1-based drugs after initial weight loss, as these patients may require alternative treatments to sustain weight loss or maintenance. To date, little is known about how prepared PCPs feel to manage this increasingly common clinical scenario.

METHODS

This was a cross-sectional web-based survey of PCPs at an academic medical center in the Midwestern United States who provide care to patients who lost coverage for GLP-1-based drugs for weight management from a large statewide insurer in 2025. Quantitative responses were analyzed descriptively and with chi-square tests; open-ended responses were analyzed with directed content analysis.

RESULTS

Among surveyed PCPs, the response rate was 51% (111/216). Approximately half (53/109, 49%) felt uncomfortable helping patients manage their weight following loss of coverage for GLP-1-based drugs for weight management. Greater comfort was associated with past experiences prescribing phentermine (aOR 4.14, 95% CI 1.69-10.18) and prescribing liraglutide (aOR 2.34, 95% CI 1.05-5.24). Most (82/110, 75%) felt that less than a quarter of their patients would be able to maintain their weight loss after losing insurance coverage and access to GLP-1-based drugs. Referral to American Board of Obesity Medicine (ABOM) board-certified physicians was preferred to support ongoing weight management of these patients (46/96, 48%).

CONCLUSIONS

Half of all PCPs at an academic medical center are uncomfortable supporting patients' transition from GLP-1-based drugs to alternative weight management treatments following loss of insurance for these agents. Additional resources, including access to ABOM-certified physicians, are needed to support patients facing this common clinical scenario.