By Betty Pio, Laura Bowen, Sarah Scolnic and
Christi Rich
GLP-1s are making an enormous impact on health care. Consumer demand for drugs such as semaglutide and tirzepatide is surging for both diabetes management and weight loss. By 2030, the number of GLP-1 users could reach 30 million people, or around 9% of the U.S. population. As supply chains stabilize after the initial demand shock, retail pharmacies will play a central role in managing patient access, education and care continuity. GLP-1s are a compelling opportunity for pharmacies to take on day-to-day, comprehensive patient care, potentially transforming the role of pharmacists.
The supply chain shuffle
In recent years, demand for GLP-1s has surged, driven by strong clinical outcomes in diabetes care, growing interest from patients seeking weight loss benefits, and a growing number of Food and Drug Administration-approved indications such as cardiovascular risk reductions — outpacing manufacturers’ ability to keep up with supply. Because these medications were on the FDA shortage list, compounding pharmacies were permitted to step in and fill the supply gap. But now that manufacturing has caught up and certain GLP-1s are coming off the shortage list, compounding pharmacies must stop producing standard, mass-compounded doses — though they can still create custom formulations for individual patients when clinically necessary.
Ample manufacturing is good news from an access standpoint: More medication is available for patients. However, for patients who are used to receiving lower-cost compounded versions of GLP-1s typically paid for out of pocket, the shift to name-brand medications from retail pharmacies will mean a significant price increase — though some manufacturers have preemptively lowered the list prices of their weight loss brands to ease the shift and manage consumer expectations. Some patients also may experience insurance hurdles as they transition to retail pharmacies, as prior authorization requirements for brand-name GLP-1s are becoming more stringent through broader payer efforts to manage growing utilization and costs.
Patients using GLP-1s for weight loss alone are often new to prescription pharmacotherapy and may require additional support navigating everything from medication access and insurance coverage to side effects and ongoing adherence. Retail pharmacies will need to work closely with patients to educate them about why the changes have occurred; flag any differences in quality, safety and cost; and counsel them about continued use to avoid disruption in care.
How will retail pharmacies manage demand for GLP-1s?
Operationally, retail pharmacies should expect an influx of new prescriptions and refills from patients who are redirected from compounding sources. This influx of patients and demand will put more pressure on retail pharmacy inventory and staffing.
Retail pharmacies
should prepare for two trends:
• Complicated supply forecasting. Some patients paying out of pocket are stockpiling medications because of a fear of future shortages. This behavior could strain retail pharmacy inventory by accelerating local demand beyond expected refill cycles, making it harder for pharmacies to maintain consistent stock levels. Pharmacists can help alleviate supply issues by educating patients on the current state of drug availability. In addition, some pharmacies may need to use wait lists to manage supply as demand grows.
• Increased pharmacy workload. Pharmacists will need to spend more time focused on GLP-1 medication counseling, side effect management and refill logistics. Given the broader health and wellness focus in many retail pharmacy settings, patients may also seek guidance on what they can or can’t eat and which nutritional supplements found in-store may support their treatment or mitigate side effects.
Retail pharmacists’ evolving role in patient care
Unlike diabetes patients, who are used to chronic medication regiments, the emerging patient base using GLP-1s for weight management may be new to pharmacotherapy and will need tailored support. Pharmacists play a vital role in educating these patients on how to navigate co-pays and insurance reimbursement, injection techniques and medication adherence.
Specifically, during the first eight to 12 weeks, patients will need heightened engagement with their pharmacist. This initial period is when patients are most likely to experience side effects such as nausea, vomiting or gastrointestinal discomfort. For some patients, the side effects can be acute. Pharmacists should proactively counsel patients during this window to manage expectations, monitor side effects, advise on lifestyle changes, and intervene to support adherence and reduce discontinuation risk. Pharmacists will need to work closely with patients and doctors to ensure successful outcomes, a collaboration that could be greatly enhanced by improving interoperability between pharmacy systems and providers’ electronic health records with real-time data sharing.
Preparing for the next wave
GLP-1 use is forecasted to reach $471 billion in value in the U.S. alone by 2031, driven by expanding indications and continued innovation. Emerging treatments in the pipeline, such as oral GLP-1s and dual mechanisms of action, will accelerate demand. Retail pharmacies can prepare for the next wave by strengthening relationships with prescribers and payers, building internal education and patient support capabilities, and staying agile with sourcing to overcome any shortages.
The bottom line: GLP-1s represent both a challenge and an opportunity for retail pharmacy. Although these drugs are a health breakthrough, they have also introduced supply chain issues and a frontline care delivery challenge. Weight loss patients will need more support than typical chronic care patients, especially in the early months of therapy. Pharmacists are uniquely positioned to fill this gap, but they need the resources to support both access and outcomes.
Retail pharmacy can — and should — be a clinical leader in this moment. Pharmacies that enact proactive strategies now (investing in patient education, early side-effect support, payer navigation and capacity planning) will win in the long term.
Betty Pio is a partner in the health practice at Kearney, a global strategy and management consulting firm. She can be reached at betty.pio@kearney.com. Laura Bowen is a principal in the health practice at Kearney. She can be reached at laura.bowen@kearney.com. Sarah Scolnic is a principal in the health practice at Kearney. She can be reached at sarah.scolnic@kearney.com. Christi Rich is a manager in the health practice at Kearney. She can be reached at christi.rich@kearney.com.
