Balancing demand and evidence: MTDM’s oversight of GLP-1 prescribing
Authors: Susanne Burns, Amanda Popko and Allison Cebulko
In response to the rising cost and growing demand for GLP-1 receptor agonists, Specialty MTDM, in collaboration with the Value & Strategy team, implemented a systemwide initiative designed to make sure prescribing practices remain clinically appropriate and financially sustainable. GLP-1 therapies, used for Type 2 diabetes and obesity, have gained widespread popularity, prompting the need to create an ecosystem that protects medication access for patients realizing maximal therapeutic impact.
To address this challenge, a multidisciplinary team was assembled to define clinical best practices for the use of GLP-1 therapies in both diabetes and obesity management. This framework emphasized evidence-based criteria, including patient eligibility, therapeutic alternatives and expected outcomes. The goal was to guide providers toward high-value prescribing decisions that balance clinical benefit with cost-effectiveness, while also supporting long-term sustainability.
The cornerstone of the initiative was the implementation of an ambulatory order review queue — a novel workflow enhancement that positioned clinically trained pharmacists to review GLP-1 prescriptions before transmission to the pharmacy. This proactive step allowed pharmacists to validate indications, check alignment with best practices and engage prescribers when clarification or alternative therapies were warranted. By integrating pharmacists into the prescribing workflow, the review process improved prescribing accuracy, reduced unnecessary utilization and fostered meaningful collaboration between pharmacists and providers.
Beyond clinical oversight, the initiative emphasized education and communication.
Pharmacists provided feedback to prescribers, shared guidance on formulary changes and helped navigate therapeutic alternatives when coverage or cost barriers were identified. This approach not only supported optimal prescribing, but also strengthened provider confidence in navigating a rapidly evolving therapeutic landscape.
Through these coordinated efforts, MTDM demonstrated how health systems can respond to market pressures with thoughtful, evidence-driven strategies. By prioritizing clinical integrity and operational oversight, the initiative helped mitigate unnecessary costs while preserving access to essential therapies. As demand for GLP-1 agents continues to grow — driven by expanding indications and public awareness — this model offers a scalable blueprint for sustainable prescribing practices that serve patients and payors alike.
