Off-Label GLP-1 Prescribing Rose 15-Fold From 2021 to 2025, Study Finds
A study published in Obesity analyzed medical records from over 92 million U.S. adults and found that off-label use of GLP-1 medications — prescribing to patients without documented obesity or diabetes — increased 15-fold between 2021 and 2025. The research documents a surge in prescribing outside FDA-approved indications during a period of intense commercial and clinical interest in GLP-1s for weight management. For Medicaid programs, rising off-label use raises questions about pharmacy benefit management, prior authorization protocols, and whether state fee-for-service or managed care plans are covering GLP-1s for conditions not meeting medical necessity criteria tied to approved diagnoses.
Medicaid programs managing GLP-1 utilization must assess whether current prior authorization and medical necessity edits effectively prevent coverage of off-label prescriptions, as uncontrolled off-label use can drive pharmacy spending without evidence-based clinical justification.
Pharmacy · Managed Care
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