GLP-1 supply is normalising; access still depends on indication
Manufacturing capacity expansion has eased the chronic supply shortfall that defined 2023-24, but reimbursement variation by indication - obesity vs diabetes vs cardiovascular risk reduction - continues to define who can actually start therapy.
The acute shortage that gated GLP-1 starts in 2023 and into 2024 has materially eased as both Novo Nordisk and Eli Lilly brought additional fill-finish and API capacity online. The bottleneck has shifted from manufacturing to coverage.
Coverage policy varies sharply by indication. Type 2 diabetes coverage is broad and stable. Cardiovascular risk reduction (post-SELECT) coverage is following indication labels but with notable payer-specific PA criteria. Obesity coverage remains the most contested: many commercial plans cover, Medicare does not, and Medicaid coverage is patchwork by state. The cost-of-coverage politics here are still being fought.
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