Global Eligibility and Policy Implications for GLP-1 Receptor Agonists

Mass General Brigham analysis finds that more than 27% of adults worldwide meet common GLP‑1 eligibility criteria—creating a candidate pool large enough to reshape prescribing demand, payer coverage rules, and clinical workflows across health systems.

Earlier studies reported substantially lower, country-specific eligibility rates or evaluated select clinical cohorts rather than population-representative samples. That difference suggests a reassessment of capacity and coverage planning is warranted, since broader eligibility could alter short-term workflow and formulary priorities.

99‑country analysis pooled roughly 810,000 adults from 99 countries and assessed eligibility using BMI thresholds combined with defined metabolic comorbidities such as type 2 diabetes, hypertension, and related cardiometabolic conditions. Eligibility clustered higher among women and older adults and was often greater in many low- and middle-income settings compared with some high-income jurisdictions—patterns that reflect both higher measured adiposity and the geographic distribution of metabolic disease burden. Those disparities underscore equity and prioritization implications: uniform coverage rules will differentially affect populations already at higher eligibility rates.

Clinically, the immediate consequence will likely be a rapid rise in prescription demand and administrative burden across ambulatory clinics and retail and specialty pharmacies. Anticipated operational pressures include increased prior-authorization workload for clinical teams; inventory and supply concerns as utilization concentrates; constrained appointment and monitoring capacity for baseline evaluation and follow-up; and intensified workforce training needs for counseling, adverse-effect recognition, and titration protocols. Pharmacy logistics may face short-term mismatch risks while payers adjudicate coverage criteria. Systems that align coverage policy, inventory strategy, and staffing plans now can avoid reactive redistribution of resources when demand materializes.

Anticipating these shifts and building proactive, evidence-based coverage and logistics strategies will help manage demand efficiently as eligibility expands.

Key Takeaways:

• More than 27% of adults meet common GLP‑1 eligibility criteria, creating a substantially larger candidate pool and increasing potential prescription volume.
• Women, older adults, and people in lower-income regions show higher eligibility—concentrating equity and prioritization challenges for payers, clinics, and global health programs.
• Expect accelerated payer deliberations and operational shifts: prior-authorization workflows, stock planning, appointment capacity, and staff training will need redesign to manage rising clinical demand.