The operational reality of supplying GLP-1 therapeutics as essential medicines

As the market for GLP-1 therapies surges, so do the complexities around equitable access and sustainable delivery.

While widespread adoption has accelerated demand, it’s also triggered supply constraints, diluted patient outcomes and spotlighted the urgent need for supportive infrastructure. With the WHO now prioritizing GLP-1s for high-risk populations and raising red flags around access inequity, the focus is shifting. For CDMOs and pharma service providers, the challenge (and opportunity) lies in designing scalable, cost-effective models that democratize access, not just meet demand.

The ramarketing review offers vital industry knowledge to keep you in the know, featuring a different ramarketing expert each month to deliver headline highlights.

Introducing January’s sector expert

Geoff Potjewyd, PhD, Senior Scientific Content Writer

Though his PhD was in regenerative medicine, Geoff’s research explored the cellular and molecular complexities of neurodegeneration. Since leaving the lab, Geoff has channelled that analytical approach into written strategy, translating complex science into clear, targeted content that aligns with client objectives.

Why chronic care models demand an integrated supply chain

The challenge of sustaining GLP-1 supply has brought access and supply planning to the top of the agenda. The transition is strengthened by the recent WHO guidelines, which explicitly frame obesity as a chronic condition requiring long-term care, rather than episodic treatment [1]. This distinction matters because it changes the priority from simple “product availability” to “system readiness.” As reinforced by the accompanying JAMA Special Communication, responsible access is a shared mandate. Pharmaceutical supply should be matched by a wider care ecosystem, including the behavioral support necessary to address the societal challenge of obesity. This integration is designed to prevent the “fragmented use,” characterized by supply gaps and inconsistent dosing, that leads to poor outcomes [2].

For the industry, this positions supply capacity as a core component of ethical access. If treatment requires long-term maintenance to be effective, the industrial challenge is to engineer cost structures that enable sustained global use, not just short-term demand. Supply, evidence and affordability are increasingly being judged together as a single metric of ethical allocation.

Aligning reimbursement with sustained clinical outcomes

Affordability often determines whether access strategies can hold up at scale. ICER’s 2025 white paper outlined specific mechanisms to align price with value. It recommends that payers implement clear eligibility criteria based on clinical benefit while calling for manufacturers to adopt outcomes-based pricing models. These models would link reimbursement rates to sustained weight loss or cardiovascular improvements, rather than just prescription volume [3].

This economic reality was reinforced by data from Evernorth’s 2025 Pharmacy in Focus report. It established a baseline for the intense GLP-1-driven cost pressure, flagging high discontinuation rates and uneven uptake as major barriers to durable value. Crucially, the report identifies enhanced patient support and real-world data as the essential mechanisms to strengthen longer-term sustainability [4].

This pressure to demonstrate tangible value is particularly pertinent for generic manufacturers preparing for market entry. By the end of 2026, semaglutide will be off-patent for countries housing 40% of the total global population and an estimated 33% of the world’s obese adult population [2, 5]. Although some market patents hold until 2030, for these new entrants, success will likely hinge on tangible value and products that deliver the same sustained outcomes as the originators, rather than price competition.

Manufacturing efficiency directly impacts patient adherence

Pharmacy trend data from Evernorth also reveals a historic inflection point. For the first time, traditional drug spending has outpaced specialty drug spending, a trend largely driven by the surge in demand for GLP-1 therapeutics [4].

This volume is straining financial limits. US employers, who fund the majority of commercial health plans, are reaching the saturation point of what they can absorb. The result is an accelerated move toward cost-shifting, where employers increase deductibles and co-pays, placing a greater financial burden directly on employees [6].

This creates a specific operational challenge for the supply chain. When the end-user pays more out-of-pocket, their price sensitivity to the medication increases. If manufacturing inefficiencies keep costs high, discontinuation rates inevitably rise.

For CDMOs, CROs and supply partners, manufacturing resilience and verified scale are now part of the access story. They directly influence continuity of supply and confidence in delivery. Evidence plans need to reflect this stricter economic reality, and supply partners are now tasked with proving they can deliver at a price point that makes long-term adherence viable [4, 6].

Communicating viability in a cost-constrained market

The financial limits and ethical questions raised by the WHO and Evernorth data create a new standard for the supply chain. Global health systems and sponsors are effectively asking the same question: can this product be supplied consistently at a price the system can absorb?

For pharma services, a clear opportunity exists to differentiate by connecting manufacturing data to long-term viability. Marketing leadership will involve moving from general capacity statements to address the specific efficiencies that allow for sustainable access.

At ramarketing, we understand these sector-specific nuances of cost and supply. We help organizations structure these complex arguments into clear messaging that resonates with sponsors facing these exact pressures.

References

[1] WHO. “WHO issues global guideline on the use of GLP-1 medicines in treating obesity.” World Health Organization. 2025. https://www.who.int/news/item/01-12-2025-who-issues-global-guideline-on-the-use-of-glp-1-medicines-in-treating-obesity

[2] Celletti, Francesca; Jeremy Farrar et al. “World Health Organization guideline on the use and indications of glucagon-like peptide-1 therapies for the treatment of obesity in adults.” JAMA. 2025. https://waltersport.com/wp-content/uploads/2025/12/JAMA-World-Health-Organization-Guideline-on-the-Use-and-Indications-of-Glucagon-Like-Peptide-1-Celletti-et-al.-2025.pdf

[3] ICER. “Examining strategies to ensure affordable access for obesity medications.” Institute for Clinical and Economic Review. 2025. https://icer.org/assessment/strategies-affordable-access-for-obesity-medications-2025/

[4] Patel, Urvashi. “Pharmacy in Focus: Navigating the GLP-1 conundrum. Demand, cost and sustainability.” Evernorth Research Institute. 2025. https://www.evernorth.com/sites/default/files/2025-03/pharmacy-in-focus-full-report-2025.pdf

[5] IQVIA. “Off-patent semaglutide.” IQVIA. 2025. https://www.iqvia.com/locations/emea/blogs/2025/07/off-patent-semaglutide

[6] Sclafani, Philip. “How Pharma Can Navigate Innovation and Cost Pressures in the GLP-1 Era.” Pharmaceutical Commerce. 2025. https://www.pharmaceuticalcommerce.com/view/how-pharma-navigate-innovation-cost-pressures-glp-1-era