How to Help Your Patients Save Money on GLP-1 Therapy After Adlyxin: A Provider's Guide

With the discontinuation of Adlyxin (lixisenatide) in January 2023, every patient who was previously prescribed the Adlyxin Starter Kit or maintenance pack needed a clinical transition. For most practices, this meant switching patients to once-weekly GLP-1 agents or Soliqua 100/33. But with GLP-1 medications consistently ranking among the most expensive drug classes on the US market, affordability is a major barrier to successful transitions. This provider guide summarizes the current landscape of GLP-1 savings programs, prior authorization strategies, and patient access tools.

Understanding the GLP-1 Cost Landscape in 2026

List prices for branded GLP-1 agents range from approximately $850 to $1,400 per month without insurance. For reference, historical pricing for Adlyxin was approximately $675–$757 per month before discontinuation — slightly lower than the current market leaders. Patients transitioning to Ozempic (semaglutide) or Mounjaro (tirzepatide) will typically see higher list prices, making savings programs and insurance coverage critical.

The cost picture improves substantially with insurance and manufacturer programs. Most commercial plans cover GLP-1 agents for type 2 diabetes after prior authorization. Manufacturer savings cards can reduce commercially insured patient out-of-pocket costs to as low as $25/month. The 2026 Medicare Part D $2,100 annual out-of-pocket cap also improves affordability for Medicare beneficiaries.

Manufacturer Savings Programs: What's Available in 2026

Novo Nordisk — Ozempic and Victoza (semaglutide, liraglutide): Commercially insured patients with a valid Novo Nordisk savings card may pay as little as $25/month for Ozempic. NovoCare patient assistance program provides free medication for eligible uninsured or low-income patients. Website: novocarecares.com; Phone: 1-833-NOVO4ME

Eli Lilly — Trulicity and Mounjaro (dulaglutide, tirzepatide): Lilly savings card offers copay reductions to as low as $25/month for commercially insured patients. Lilly Cares Foundation provides free medication to qualifying uninsured or underinsured patients. Website: lillycares.com; Phone: 1-800-545-5979

Sanofi — Soliqua 100/33 (insulin glargine/lixisenatide): Sanofi Patient Connection program provides free medication for eligible uninsured or low-income patients; commercially insured patients may also qualify for copay reduction. Website: sanofipatientconnection.com; Phone: 1-888-847-4877

Prior Authorization: Strategies for Faster Approvals

Prior authorization is the primary obstacle for most GLP-1 prescriptions. Most commercial plans require PA for GLP-1 agents. Here is how to increase first-pass approval rates and reduce turnaround time:

Document diabetes diagnosis and current HbA1c clearly. PA criteria typically require type 2 diabetes with HbA1c above threshold (commonly ≥7.0% or ≥7.5%), with failure or inadequate response to metformin or other first-line agents.

Document step therapy completion. Many plans require documented use of metformin (unless contraindicated) before approving GLP-1 agents. Note current and prior diabetes medications in the PA request.

Include cardiovascular or renal comorbidities. Patients with ASCVD, CKD, or HFrEF may qualify for faster or exception-basis approval of guideline-preferred GLP-1 agents. Document these conditions explicitly.

Use e-prescribing with real-time benefit check. Many EHR systems now support real-time formulary and PA requirement checks at the time of prescribing, which can help you select the covered GLP-1 on the patient's specific plan formulary.

Appeal promptly if denied. Initial PA denials for GLP-1 agents can often be overturned with a peer-to-peer review or formal appeal. Many initial denials are based on missing information rather than true clinical ineligibility.

Medicare Part D and GLP-1 Coverage in 2026

The 2026 Medicare Part D redesign introduced a $2,100 annual out-of-pocket cap for all Part D beneficiaries. This significantly improves affordability for Medicare patients on GLP-1 agents prescribed for type 2 diabetes, as these drugs are covered under Part D when prescribed for diabetes. Note that GLP-1 agents prescribed for obesity (weight management) only may not be covered by Part D — check the specific indication on the prescription.

Manufacturer savings cards are generally NOT valid for Medicare Part D patients (federal anti-kickback provisions apply). For Medicare patients, the most relevant assistance is the Medicare Extra Help (Low Income Subsidy) program, which can reduce Part D copays to $0–$4 for low-income beneficiaries.

Patient Assistance Programs (PAPs) for Uninsured Patients

For patients without insurance or with inadequate coverage, manufacturer patient assistance programs (PAPs) are the strongest resource:

NovoCare (Novo Nordisk): Covers Ozempic, Victoza, Rybelsus; eligibility based on income (<400% FPL) and lack of adequate coverage; physician-assisted application

Lilly Cares Foundation: Covers Trulicity, Mounjaro; eligibility based on income and insurance status; physician or patient can apply

RxAssist.org and NeedyMeds.org: Independent directories of manufacturer and non-profit PAPs; useful for quick cross-referencing of available assistance for a specific medication

Helping Patients Find Their Medication in Stock

Affordability is only part of the access equation. Even with a prescription and a savings card, patients may struggle to find their GLP-1 in stock at a local pharmacy. Direct your office staff and patients to medfinder for providers to reduce the volume of pharmacy callbacks coming into your practice. See also our provider guide to helping patients find their GLP-1 for a complete transition workflow.