Why Do People Stop Taking GLP-1? Cost Matters

Why do people stop taking GLP-1 medicines? Cost, side effects and trouble getting refills can all play a part. New research puts a sharper focus on the bill: having insurance doesn't necessarily make treatment affordable enough to continue.

GLP-1 medicines copy a gut hormone involved in appetite and blood sugar. Semaglutide is one example. The latest cost study is about that medicine, and its findings make the ongoing monthly bill worth discussing before treatment begins.

Why do people stop taking GLP-1? What the new study found

As of October 1, 2026, the day this article was written, the University of Georgia's September 30 release highlights a cost study published in JAMA Health Forum on August 28, 2026.

Shin and colleagues studied 8,914 adults with continuous commercial insurance and obesity, without type 2 diabetes, who began semaglutide in 2021–2022. Follow-up lasted one year.

Adherence meant prescription supply covering at least 80% of follow-up days. Researchers calculated proportion of days covered, or PDC: the share of days supplied by filled prescriptions.

The paper divided patients into five spending groups. These are the unadjusted results:

About three in four fell below the threshold even in the lowest group. After accounting for measured patient differences, poorer adherence remained associated with the upper spending groups.

That does not mean all permanently stopped. Refill records cannot establish whether each dose was used.

What the finding means for a monthly budget

The university's release quotes lead author Eunhae Shin: “out-of-pocket costs matter.” It also describes insurance requirements that can interrupt continuation, while noting these were not directly measured.

For someone considering treatment, the useful question is broader than “Can I pay for the first shipment?” It is “What will the next several months actually require?” A first-month offer and the regular monthly bill answer different questions.

A clear quote gives the regular charge, the length of any introductory offer and the services included. It also explains what happens at renewal. Without those details, two apparently similar offers can be difficult to compare.

These are reasonable questions for a visit:

• What is the ongoing monthly total after any introductory offer?
• Are the evaluation, dispensing, shipping and follow-up included?
• Can the charge change with the prescription or supply length?
• How are renewal, cancellation and an interrupted shipment handled?

A predictable, stated monthly price before the first shipment matters alongside the headline number. Predictable does not automatically mean affordable. It means the patient can judge the commitment with fewer surprises.

The semaglutide cost guide explains the different payment routes. This new finding adds a reason to compare the recurring bill, rather than only the first payment.

Cost is one reason, alongside side effects and supply

A separate Cleveland Clinic study helps explain actual stopping. Gasoyan and colleagues, Obesity, 2025 reviewed 288 randomly selected adults without diabetes who stopped semaglutide or tirzepatide within their first year.

Nearly half, 47.6%, stopped because of cost or insurance problems. Side effects accounted for 14.6%, and medication shortages for 11.8%. Those percentages describe people who had already stopped, not everyone who started treatment.

That distinction matters. A refill problem calls for a different conversation from an unpleasant physical reaction. Treating every gap as a money problem can miss what the patient is actually experiencing.

Tirzepatide belongs in that discussion because the Cleveland Clinic study included it. The new University of Georgia cost study did not. Its findings cannot tell a patient that switching to tirzepatide would solve an affordability or tolerability problem.

The best comparison includes the medical fit, the recurring bill and a clear way to reach the prescribing team. A different product card is a starting point for that conversation, not a treatment decision.

What the study does not mean

Higher spending was associated with poorer adherence; the study did not prove cost caused every gap. It also did not test compounded products or establish a universal affordable price.

The findings aren't a forecast for one person's treatment. A group percentage cannot reveal which obstacle will matter most in a particular household. It is more useful as a reason to make room for the financial conversation during care.

Trial results need care, too. In STEP 1, NEJM, 2021, the main analysis included participants regardless of treatment discontinuation. Trial averages aren't reserved only for perfect adherence, and they aren't individual promises.

Semaglutide and tirzepatide prescribed through Promise are dispensed by a licensed U.S. compounding pharmacy as compounded medications, which are different from an FDA-approved product: the formulations offered here are not FDA-approved. A compounded medication is prepared by a pharmacy for an individual prescription.

As of October 1, 2026, the day this article was written, FDA explains that it does not review compounded drugs for safety, effectiveness or quality before marketing. A licensed provider may still prescribe a compounded formulation when appropriate; that decision is between the patient and the doctor.

A lower bill cannot establish that two preparations are equivalent. The product and the care around it both belong in the discussion.

What to watch before the next refill

The next useful evidence would show whether reducing patient costs actually improves continued treatment, rather than merely showing that spending and refill patterns travel together. It would also separate financial interruptions from side effects more clearly.

For a patient, the nearer question is whether the next refill will follow the same terms as the first. A coverage notice or renewal message can change the budget even when the prescription stays the same. The guide to insurance dropping GLP-1 coverage explains how those changes differ.

If treatment becomes difficult to sustain, the prescribing conversation can include both the reason and the plan after a gap. The guide to what happens when semaglutide stops covers that separate question.

At Promise, a licensed provider reviews every request, and not everyone qualifies. An honest discussion of affordability belongs in that review, alongside medical history and treatment goals.