Which GLP1 Agent is Right for Your Patient?
The number of patients asking about Glucagon-like peptide-1 medications (GLP-1s) is on the rise, with nearly 12 percent of Americans having used these drugs for weight loss, including about one-fifth of women aged 50 to 64. With these numbers on the rise, it’s likely that you’ll have more patients asking about weight loss medications in the exam room.
With an expanding market of incretin-mimetic options, it can be challenging to identify the “best” option for each patient. Here are a few considerations:
- Relevant FDA-approved indication: As a start, are you primarily using the medication for diabetes or obesity?
- Other comorbidities: An agent with cardiovascular disease (CVD) benefit would be preferred for a patient with a history of heart attack (MI) or cerebrovascular accident (CVA). Comorbid obstructive sleep apnea (OSA) might steer you towards Zepbound. Medicare does not currently cover weight loss medications, but may cover Wegovy for obesity with CVD (history of MI, CVA, or peripheral artery disease (PAD)) or metabolic dysfunction-associated steatohepatitis (MASH). Likewise, Zepbound may be covered for obesity with moderate-to-severe OSA (AHI > 15).
- Effectiveness: Tirzepatide (an agonist of both GLP-1 and GIP receptors) is more effective at blood glucose lowering and weight loss than traditional GLP-1 receptor agonists.
- Tolerance: While gastrointestinal side effects are common, tolerability is patient-specific and varies across products.
- Insurance Coverage: Payor formularies may restrict affordable options or not cover at all for weight loss.
For more information about prescribing GLP-1 medications, VHAN members can consult the members-only comparison chart here.