How Health Disparities Are Limiting GLP-1 Receptor Agonist Use

Racial health disparities in diabetes and obesity management remain a pressing concern, particularly in the use of GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro or Zepbound). These medications offer promising benefits but are often underutilized by African Americans, a population with disproportionately higher rates of type 2 diabetes and obesity.

Benefits of GLP-1 Receptor Agonists

GLP-1 receptor agonists provide multiple health benefits, including:

• Improved Glycemic Control: These medications help regulate blood sugar levels effectively.
• Weight Loss: Proven to aid in significant weight reduction, crucial for diabetes and obesity management.
• Heart Health: Research indicates that these drugs reduce the risk of cardiovascular disease.
• Neurocognitive Protection: A recent study linked their use to a 12% reduction in the risk of Alzheimer’s disease.

Risks and Side Effects of GLP-1

While GLP-1 receptor agonists offer substantial benefits, they also come with risks, such as:

• Gastrointestinal Issues: Nausea, diarrhea, and vomiting, particularly in the initial stages of treatment.
• Increased Risk for Certain Conditions: Studies suggest a higher likelihood of pancreatic and joint disorders among users.

Racial Disparities in GLP-1 Prescription

Despite the advantages, African Americans are less likely to receive GLP-1 receptor agonists. Research from the U.S. Veterans Affairs Medical System reveals that Black veterans with diabetes had 26% lower odds of being prescribed semaglutide compared to white veterans. Another study found that Black patients are 20% less likely to begin newer diabetes treatments, exacerbating existing health disparities.

Why Equitable Access Matters

African Americans are disproportionately affected by diabetes-related complications, such as kidney disease and heart failure. Increasing access to GLP-1 receptor agonists is crucial for bridging the gap in healthcare outcomes and enhancing the quality of life for this underserved community.

What’s Changed in 2026: Lower Prices and New Coverage

Some of the affordability barriers behind these disparities are starting to shift — but “starting to” is the key phrase, and knowing the details matters for how you advocate for yourself.

In late 2025, the federal government struck pricing deals with Eli Lilly and Novo Nordisk that changed the GLP-1 landscape:

• Medicare now covers GLP-1s for obesity, not just diabetes or heart disease, starting mid-2026 — a first. Beneficiaries pay a $50/month copay; Medicare’s negotiated price is $245/month.
• Medicaid gets access to the same $245 pricing, but coverage depends on whether your state opts in — it’s not automatic everywhere.
• TrumpRx.gov, a direct-to-consumer discount platform, launched in early 2026 for people who are uninsured, underinsured, or don’t qualify through Medicare/Medicaid. Cash prices started around $350/month, with a path down toward $245.
• CMS also introduced the BALANCE model, a voluntary program encouraging state Medicaid programs to expand obesity-drug access with built-in lifestyle support.

None of this closes the disparity gap on its own — access still depends heavily on which state you live in, whether your provider brings these medications up, and whether you know to ask. That’s exactly where self-advocacy comes in. If you’re eligible for a GLP-1 and haven’t been offered one, it’s worth asking your provider directly:

• “Am I a candidate for a GLP-1, and if so, why haven’t we discussed it?”
• “Does my state’s Medicaid program cover GLP-1s for obesity, or only diabetes?”
• “Is TrumpRx or a manufacturer savings program an option for me if insurance doesn’t cover it?”

Bringing the specific dollar figures and program names into the conversation — rather than a general “can I get this medication” — makes it harder for cost or coverage assumptions to end the conversation before it starts.

Our free GLP Medications Violet Sheet gives you a place to write these questions down before your appointment, so you walk in prepared instead of improvising.

Sources

1. Financial Times. (n.d.). Diabetes drug linked to lower Alzheimer’s risk but some other risks identified. Retrieved from https://www.ft.com/content/015e989d-75ca-4cbe-b315-13f910e35b62
2. Hopkins Medicine. (2022). Study finds minorities who most need new diabetes medications aren’t getting them. Retrieved from https://www.hopkinsmedicine.org/news/newsroom/news-releases/2022/01/study-finds-minorities-who-most-need-new-diabetes-medications-arent-getting-them
3. Reuters. (2024). U.S. minority veterans face unequal access to Ozempic, Wegovy, study finds. Retrieved from https://www.reuters.com/business/healthcare-pharmaceuticals/us-minority-veterans-face-unequal-access-ozempic-wegovy-study-finds-2024-11-11
4. Time. (2025). The health risks and benefits of weight loss drugs like Ozempic and Wegovy. Retrieved from https://time.com/7207986/health-risks-benefits-weight-loss-drugs-ozempic-wegovy
5. CNBC. (2025). Trump announces deals with Eli Lilly, Novo Nordisk to slash weight loss drug prices, offer some Medicare coverage. Retrieved from https://www.cnbc.com/2025/11/06/trump-eli-lilly-novo-nordisk-deal-obesity-drug-prices.html
6. KFF. (2026). Medicaid Coverage of and Spending on GLP-1s. Retrieved from https://www.kff.org/medicaid/medicaid-coverage-of-and-spending-on-glp-1s/