Implementation of an Integrated Cardiology/Pharmacy GLP-1 Receptor Antagonist Prescribing to Improve Utilization and Cardiovascular Risk
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Background
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective therapies for cardiovascular risk reduction, including in non-diabetic populations. However, utilization is hindered by high costs, poor insurance coverage, supply issues, and complex dosing regimens.
Methods
This single-center, retrospective cohort study included 385 eligible patients referred to a multidisciplinary cardiology/pharmacy GLP-1 RA program between June 2023 and March 2024. Pharmacists selected medications, managed insurance processes, and conducted follow-up for titration and adherence. Primary endpoints were rates of initiation and continuation. Secondary outcomes were changes in cardiovascular risk factors.
Results
Two thirds of patients referred to the program initiated GLP-1 RA therapy, and over 80% who followed up continued their medication, experiencing statistically significant reductions in weight, systolic blood pressure, and hemoglobin A1C.
Conclusions
This integrated cardiology/pharmacy GLP-1 RA program saw high rates of medication initiation and continuation and was associated with improvements in cardiovascular risk factors. Incorporating pharmacists into cardiovascular care can overcome key prescribing barriers and improve utilization of GLP-1 RAs to improve cardiovascular risk.
WHAT IS KNOWN
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GLP-1 receptor agonists are underutilized in cardiovascular care despite compelling evidence for risk reduction.
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Barriers such as insurance denials, prior authorizations, high out-of-pocket costs, and complex titration regimens contribute to poor real-world initiation and persistence.
WHAT THE STUDY ADDS
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Integrating pharmacists into cardiology prescribing workflows can overcome these barriers and significantly improve GLP-1 RA utilization.
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Improved access and persistence with GLP-1 RAs may help translate clinical trial evidence into real-world cardiovascular risk reduction.
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This model demonstrates a scalable approach to improving access to cardiometabolic therapies in high-risk populations.
