This blog is part of an ongoing series on A Brave New World: Therapeutic Area Deep Dives.

GLP-1 Drugs Breaking Boundaries: Beyond Diabetes and Obesity

Glucagon-like peptide 1 (GLP-1) therapies are not just for diabetes and obesity anymore—they are rewriting the rules of modern medicine. Frequently referred to as “wonder drugs,” GLP-1s are increasingly recognized for their potential well beyond the treatment of diabetes and obesity alone¹. GLP-1 brands have been steadily expanding their reach through new indications, with Ozempic and Wegovy adding cardiovascular risk reduction in 2020 and 2024 respectively, and Zepbound adding obstructive sleep apnea in 2024. Building on this momentum, Wegovy also gained FDA approval for Metabolic Dysfunction-Associated Steatohepatitis (MASH) in 2025.

Backed by strong clinical evidence, GLP-1s are winning over doctors and patients alike and are reshaping treatment paradigms across comorbid conditions. The biggest surprise: non-diabetes specialists are jumping on board, driving the fastest growth. While these providers still account for less than 20% of overall GLP-1 volume, their adoption signals a major shift in how these powerful drugs are perceived as the prescribing audience expands.

Non-Diabetes Specialists Drive New Growth in GLP-1 Prescriptions

Patients with Type 2 diabetes (T2D) and obesity often present with multiple comorbidities spanning a wide range of diseases, requiring care from diverse specialists. Historically, endocrinologists and internists dominated the GLP-1 prescription scene, but their share dropped from 93% in 2020 to 83% in 2025. The real headline, however, is that while GLP-1 prescriptions from these specialists grew by 500% in 2025, non-diabetes specialists ramped up their prescribing by a whopping 900%, signaling a seismic shift in how these game-changing drugs are used.

Prescribing trends are being driven by growing evidence that suggest GLP-1s provide benefits well beyond glucose control and weight management, spanning therapy areas from cardiovascular risk reduction to potential applications in neurological conditions such as Parkinson’s disease². As clinical data continues to expand across therapeutic areas, providers outside of diabetes and obesity care are increasingly likely to view GLP-1s as viable treatment options for their patients. The result is a fundamental change in how these therapies are perceived, with GLP-1s emerging as versatile tools with relevance across a broad spectrum of specialties.

As Comorbidities Rise, GLP-1s Gain Ground Beyond Diabetes and Obesity

Among the many conditions that frequently overlap with T2D and obesity, obstructive sleep apnea (OSA), MASH—a subset of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), hypertension, and high cholesterol are among the most prevalent. While GLP-1 therapies are not FDA indicated for all of these conditions, growing evidence suggests they can improve outcomes across each³. Because the cost of care rises as patient comorbidities increase, the value of treatment also increases. In practice, this can be seen through prior authorization requirements that often request documentation of such comorbidities, reinforcing their role in determining patient eligibility and access.

Prescription patterns further reflect this relationship—patients with diabetes or obesity are more likely to initiate GLP-1 therapy as their number of comorbidities increases. In Q1 2025, 29% of patients with four additional comorbidities filled a GLP-1 prescription within six months of diagnosis, compared to 19% of those with diabetes or obesity alone. This effect has become more pronounced over time as clinical evidence of broader health benefits continues to grow.

GLP-1s Offer New Hope When Treatment Options Are Limited

A growing share of providers are prescribing GLP‑1 therapies to manage multiple conditions, a trend particularly evident in comorbidities where few therapeutic options exist. Take MASLD and OSA, for example. Both are common among patients with diabetes and obesity, yet until recently, treatment options were mostly limited to lifestyle interventions or devices like continuous positive airway pressure (CPAP) machines. FDA-approved medications for these conditions have been scarce. In contrast, for disease areas like hypertension and high cholesterol with inexpensive and widely available treatments, GLP-1s are usually not a first-line treatment option. Instead, their use is surging in areas where traditional therapies fall short, especially in circumstances of complex or multiple comorbidities.

Recent prescribing patterns underscore this trend. In Q1 2025, 24% of patients with both diabetes/obesity and OSA initiated a GLP-1 therapy within six months of diagnosis, compared to 18% of patients with diabetes/obesity alone. This surge coincided with Zepbound’s approval for OSA, marking the largest observed difference in uptake between patients with and without a comorbidity. Similarly, 21% of patients with MASLD and diabetes/obesity began GLP-1 therapy within six months, again outpacing those without the comorbidity. Conversely, additional diagnoses of hypertension or high cholesterol did not increase GLP-1 initiation rates. While treatments can lag diagnosis and disease pre-dates treatment, these increases in treatment rates represent a positive development for many patients. These trends suggest that GLP-1s are reshaping treatment patterns most significantly in markets where few alternatives exist and where their effectiveness is increasingly valued.

Medicare Utilization of GLP-1s Rises with Broader Indications Beyond Obesity

Since Medicare does not cover anti obesity drugs when prescribed solely for weight management, utilization of weight loss indicated GLP-1s historically lagged behind their use in commercial markets. That dynamic shifted in 2024, when Wegovy gained an indication for reduced cardiovascular risk in March and Zepbound added an OSA indication in December. These label expansions unlocked new pathways for coverage, and by early 2025 the proportion of Medicare patients with diabetes or obesity initiating GLP-1 therapy rose sharply. Among patients with OSA, initiation rates increased from 16% to 21% within a single quarter, outpacing growth among commercially insured patients.

Prior to GLP-1 indication expansions into this therapy area, a similar trend appeared among patients with MASLD—a condition where evidence increasingly supports therapeutic benefit⁴. Between Q4 2024 and Q1 2025, the share of Medicare patients with comorbid diabetes or obesity and MASLD who started a GLP‑1 rose from 13% to 19%, compared with only a modest increase from 20% to 22% among commercially insured patients. Although commercial plans still account for higher overall GLP‑1 use, the rapid growth in Medicare underscores a shifting landscape in which expanded indications are driving meaningful adoption in populations previously limited by coverage restrictions.

GLP-1s Rewrite the Comorbidity Playbook

In the commercial market, new to brand GLP-1 prescriptions have surged more than 700% over the past four years, reflecting both their growing popularity and expanding evidence base. This growth has had ripple effects on common comorbid conditions associated with diabetes and obesity, including hypertension, high cholesterol, and gastroesophageal reflux disease (GERD). While GLP-1s have been shown to improve outcomes in hypertension and high cholesterol, they may exacerbate GERD symptoms, creating a complex interplay across these therapeutic areas.

Prescription trends illustrate this shift. As GLP-1 utilization expanded, new patient volume for hypertension and high cholesterol therapies declined, with 2024 marking the steepest drop, 3% for hypertension and 4% for high cholesterol. In contrast, the decline in new patient volume for GERD products slowed during the same period, consistent with evidence that GLP-1s can worsen reflux symptoms. Taken together, these patterns suggest that GLP-1 adoption is not only transforming diabetes and obesity care but also influencing prescribing behavior and patient management across a broader set of comorbid markets. All of these trends need to be tracked to understand the longer-term impact on treatment decisions.

The Bottom Line

GLP-1 therapies are not just sticking to diabetes and obesity anymore. They are breaking out and shaking up the entire healthcare scene. With fresh approvals, mounting clinical evidence, and a surge in adoption by specialists far beyond endocrinology, these treatments are rewriting the rules for managing comorbid conditions and reshaping adjacent markets. Their real strength? Tackling multiple diseases with a single prescription, making GLP-1s a disruptor in today’s medical landscape. To help navigate this shifting environment, pharma companies should consider the following imperatives:

• GLP‑1s are expanding far beyond diabetes and obesity. With new approvals for cardiovascular risk reduction and OSA, GLP‑1s are reshaping treatment paradigms across comorbid conditions and gaining traction with a broader set of providers.
• Non‑diabetes specialists are driving the fastest growth. While endocrinologists and internists still dominate prescribing, non‑diabetes specialists have increased GLP‑1 prescribing by 900% since 2020, signaling a fundamental shift in perception and adoption as audiences expand beyond traditional prescribers.
• Comorbidity burden strongly influences uptake. Patients with multiple comorbidities, especially those with limited treatment options, are significantly more likely to initiate GLP‑1 therapy.
• Coverage expansion is unlocking Medicare adoption. Label expansions in 2024 created new reimbursement pathways, leading to sharp increases in GLP‑1 use among Medicare patients, a population historically excluded from weight‑loss coverage.
• GLP‑1s are disrupting adjacent therapeutic markets. As GLP‑1 use rises, new patient volume for hypertension and cholesterol therapies has declined, while GERD treatments remain stable due to GLP‑1’s mixed impact, showing ripple effects across multiple disease areas.

GLP-1s are not staying in their old lanes—they are taking the fast track to altering the healthcare landscape. One prescription, multiple diseases, and a cascade of transformative outcomes for the industry. GLP-1s are shaking up the playbook and giving pharma companies a whole new set of moves to master. Reach out to IQVIA to learn more about building successful strategies for the obesity market.

References:

1. Ravella S. Is Ozempic the New Anti-Inflammatory Wonder Drug? TIME. April 30, 2024. Accessed October 8, 2025.
2. Drucker DJ. The benefits of GLP-1 drugs beyond obesity. Science. 2024;385(6706):258-260. doi:10.1126/science.adn4128.
3. Nevola R, Epifani R, Imbriani S, et al. GLP-1 Receptor Agonists in Non-Alcoholic Fatty Liver Disease: Current Evidence and Future Perspectives. Int J Mol Sci. 2023;24(2):1703. doi:10.3390/ijms24021703
4. Contributor A. Weight Loss Medications Show Promise in MASLD, MASH | AJMC. October 9, 2025. Accessed October 9, 2025.