GLP-1 Demand Is High. So What's Getting Between Patients and Their Next Prescription?

From our recent work on the direct-to-patient experience for a leading GLP-1 manufacturer, we're unpacking two common patient barriers and fixes.

GLP-1 Image

GLP-1 manufacturers have invested heavily in direct-to-patient platforms, savings programs, and patient support. These investments create a strong foundation, but the experience still holds meaningful opportunities for improvement that directly shapes the metrics manufacturers care about most: first fill and persistence.

Behavior design gives pharmaceutical teams a focused way to understand patient barriers, pinpoint where patients are most likely to disengage, and design support that helps them move forward.

User Barrier #1: Complex paths to access and affordability

When patients can’t tell which path to an affordable prescription will work, many give up before first fill.

Consider a scenario many GLP-1 patients will recognize: A patient decides to start treatment and turns to a manufacturer’s direct-to-patient platform to get started. The cash price gives them pause, so they enter their insurance information, expecting their plan to help cover the cost. Their plan requires prior authorization, and after several days of waiting while their prescriber’s office submits the request, coverage is denied. While skimming online message boards, they learn of a discount program, but it’s for a different form of the drug. They return to their prescriber to adjust the prescription and begin the access process again, fingers crossed.
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Each detour costs patients time, energy, and motivation, making them more likely to abandon the process before first fill.

Direct-to-patient platforms are well positioned to solve this. Manufacturers built them in part to simplify access and give patients a clearer route to therapy, and the stakes extend well beyond the first fill. A patient who reaches an affordable prescription with confidence is more likely to stay on treatment, and persistence drives both health outcomes and long-term value for manufacturers.‍

How behavior design improves access and affordability

Obviously, we want to make it easy—well, as easy as possible. But the trickier thing is getting patients to invest their effort when there’s no guarantee. Reducing friction helps, but reducing uncertainty matters even more, because patients are far more willing to invest effort when they can see where it leads.

The most effective lever is bringing information forward. Help patients proactively identify their likely access options before they begin a lengthy process. Clearly explain eligibility requirements and potential out-of-pocket costs. Show what happens after a denial, rather than leaving patients at a dead end. And throughout, set expectations about timing, documentation, and what might require prescriber involvement.

User Barrier #2: Side effects without timely support

Many patients decide whether to stay on treatment well before a refill reminder arrives.

They may have unpleasant side effects, such as digestive issues, thinning hair, or increased anxiety. They think that messaging their prescriber for help will only lead to a request to schedule another appointment. When it comes time to refill, despite all the reminders, they may conclude the treatment isn’t right for them, and they stop taking it.

GLP-1s, as well as many other therapies, involve a titration schedule where doses change over time. As their response to therapy changes, patients are quick to stop or search out their own information in online communities. Online boards are filled with tapering schedules and side effect hacks. While these sources are not validated by medical professionals, they are highly trusted. Patients feel validated that they’re not the only ones experiencing this and love the practical answers from people with firsthand experience.

For manufacturers, these moments directly shape persistence. When a patient starts questioning whether their therapy is working, another refill reminder isn't going to solve the problem. They need timely, trustworthy support that helps them understand what's happening and what to do next.

How behavior design improves persistence

Behavior design looks at decisions and timing. During titration, patients weigh what they’re experiencing now against the benefit they expect later. Side effects are immediate and tangible, while progress can feel slow or invisible. Designing for persistence means supporting patients at the moments when that balance is most likely to tip.

Alongside scheduled reminders, consider proactive check-ins around dose changes or periods when side effects are more likely. Offer credible, accessible information that acknowledges what patients are experiencing. And help patients reflect on changes they’ve experienced, recognize meaningful milestones, and connect their progress to personal goals. These moments create opportunities to address concerns before patients disengage.

At ZoCo, we help pharmaceutical teams and their DTP partners apply behavior design to understand patient barriers, pinpoint where patients are most likely to disengage, and improve first fill and persistence. If your team is working on this challenge, let’s connect.

Hannah Greene, Senior Researcher

Hannah Greene, Senior Researcher

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