At Claimable, we believe healthcare should reflect the best of what we know—not be constrained by inertia, stigma, or financial incentives that prioritize profit over patient care.
Right now, that belief is being tested. Patients eligible for GLP-1 medications are being denied coverage—denials often based on arbitrary criteria that ignore clinical guidelines and FDA approvals. As the science accelerates, coverage is moving in the opposite direction—not because the evidence has changed, but because the rebate math doesn’t work for payers.
That’s why we’re expanding our platform to support appeals for GLP-1s. We already know that the conditions they treat are urgent—affecting over half of US adults and driving a disproportionate share of preventable healthcare costs—and with compounded versions of these medications unavailable as of May 22nd, the need is more pressing than ever.
What the science is telling us
GLP-1s have evolved far beyond their original use for type 2 diabetes and weight loss. Today, they are FDA-approved not only for managing blood sugar and reducing body weight, but also for treating obstructive sleep apnea and lowering the risk of serious cardiovascular events like heart attacks and strokes.
In advanced stages of clinical review, GLP-1s are also showing promise for treating metabolic dysfunction-associated steatotic liver disease (MASLD), chronic kidney disease (CKD), pre-diabetes, diabetic retinopathy and osteoarthritis of the knee (in patients with obesity).
And the emerging science is even more far-reaching. Early research suggests that GLP-1s may play a role in reducing neuroinflammation associated with Alzheimer’s, Parkinson’s and dementia; curbing addictive behaviors tied to substance use; improving symptoms of irritable bowel syndrome (IBS), and even impacting certain types of cancer. The list of ways these medications can change — and save — lives is profound and growing fast.
For many of us, this isn’t just promising science. It’s deeply personal.
One area that strikes particularly close to home for me is metabolic dysfunction-associated steatotic liver disease (MASLD) —a condition that affects nearly a third of U.S. adults and has no approved treatment. I lost my father to complications of diabetes, including MASLD. By the time he was diagnosed, he was already suffering from liver failure. A catastrophic upper gastrointestinal bleed and emergency medical evacuation followed. It was marked by a single week that aged me years.
If therapies like this had been available earlier—maybe it would have changed the outcome.
These medications don’t just improve quality of life — they help prevent the cascade of complications that make care more expensive, less effective, and harder to access. A recent analysis of over 50 million insured lives found that GLP-1 users experienced 44% fewer hospitalizations for major cardiovascular events, and healthcare spending rose at just half the rate of similar non-users by year two.
When people stay healthier longer, it means fewer emergency interventions, fewer disability claims, and more stable, productive lives.
As new treatments emerge, access to GLP-1s is slipping away.
GLP-1s are no longer just a type 2 diabetes or weight loss drug. They represent a platform therapy with far-reaching potential across some of the most costly, intractable diseases in healthcare—and yet, access is moving in the wrong direction.
Statins. Insulin analogs. SGLT2 inhibitors. Each faced early resistance. Each is now a pillar of care. GLP-1s are on the same trajectory—but patients can’t afford to wait years for coverage to catch up.
The barriers to coverage aren’t scientific. They’re systemic. And these delays and denials don’t just hurt patients. They affect providers, employers, and the healthcare system as a whole.
With compounded versions of branded GLP-1s off the market as of May 22, 2025, affordability has collapsed. Direct-pay options run $400 to $700 a month—pricing out the majority who should qualify for initial or continued treatment. Copay cards and assistance programs offer temporary relief—but they’re not available to everyone, and they don’t solve the broader access problem.
Those who attempt to gain coverage face increasingly restrictive and often arbitrary criteria. From BMI requirements that far exceed standard criteria, to mandating costly weight management programs and shrinking approval windows from 12 months to just one, new barriers are being constantly invented and implemented to limit access.
Turning evidence into access—one appeal at a time.
At Claimable, we help patients push back. We handle the administrative burden—challenging denials, navigating appeals, and ensuring every request is grounded in current science, regulatory precedent, and standard of care.
GLP-1s are the next frontier in chronic disease prevention. But for patients to benefit, access must match the evidence.
The dream is to prevent people from becoming patients, to keep them present in their lives.
We’re here to make that happen— appeal by appeal. We’re ready to go.
Warris Bokhari
CEO, Claimable
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