Insurance
Home›Insurance›Health Insurance›Study finds most postpartum GLP-1 use lacks policy qua…
Study finds most postpartum GLP-1 use lacks policy qualifying diagnoses
Postpartum GLP-1 initiation among commercially insured women rose from 0.08% in early 2018 to 1.9% in Q1 2025, highlighting a gap between coverage triggers and real-world use.
Insurance Business reports that most employer GLP-1 coverage policies rely on a clinical trigger tied to diagnoses such as type 2 diabetes, obesity, or a related condition. But a JAMA study suggests that trigger is misaligned with how the drugs are being used in postpartum care.
The study analyzed commercial insurance claims covering more than one million deliveries from 2018 through March 2025. It found the overall postpartum GLP-1 initiation rate increased from 0.08% in the first half of 2018 to 1.9% by the first quarter of 2025.
Researchers from the University of Southern California and Indiana University, led by Sih-Ting Cai of the USC Schaeffer Center for Health Policy and Economics, described the work as the first US analysis of postpartum GLP-1 initiation using commercial claims data. The research was funded by the National Institute for Health Care Management Foundation.
Insurance Business also notes that in the second half of 2024, women with overweight or obesity made up 40.4% of postpartum GLP-1 initiators, while many initiators lacked a documented qualifying predelivery diagnosis under the typical policy framework.