Rethinking GLP-1 Strategy Through a Total Cost of Care Lens

A solid utilization management strategy for GLP-1 receptor agonists (GLP-1 RAs) is good fiscal responsibility and an important lever in managing total cost of care. A nimble approach that adapts to emerging clinical evidence is essential, particularly because increased pharmacy spend can often reduce downstream medical costs. Pharmacy strategy is most effective when evaluated through a total cost lens, not pharmacy spend alone. Ensuring convenient access to GLP-1 RAs for members with type 1 diabetes mellitus, when prescribed by a specialist, is a clear example. Recent evidence shows that adults with type 1 diabetes treated with GLP-1 or other incretin-based therapies experienced lower all-cause mortality, fewer hospitalizations, and reduced healthcare utilization without increased risk of diabetic ketoacidosis or hypoglycemia (Garg et al., 2026). When aligned with evidence-based utilization management, GLP-1 access can support better outcomes while responsibly controlling overall healthcare costs.

Garg, S., Kim, S., Ford, A., et al. (2026). All-cause mortality and health care resource utilization in patients with type 1 diabetes treated with glucagon-like peptide 1 receptor agonists/glucose-dependent insulinotropic polypeptide. Diabetes Technology & Therapeutics, 0(0). https://doi.org/10.1177/15209156251403555