Key takeaways
- A new study shows 85.4% of multiple sclerosis patients eligible for GLP-1s have never used them.
- Only 7.4% of MS patients surveyed have ever taken a GLP-1, compared to 12% of the general US public.
- Researchers highlight critical gaps in care coordination and potential inequities in drug access.
- Gastrointestinal side effects remain a primary safety concern due to baseline MS bowel issues.
What happened
A study published in the Multiple Sclerosis Journal reveals that 85.4% of multiple sclerosis (MS) patients who qualify for GLP-1 receptor agonists have never used them. Despite high rates of obesity and type 2 diabetes among people with MS, researchers found that only 14.6% of medically eligible patients in the studied NARCOMS Registry have ever taken these highly effective metabolic medications.
Why it matters
For patients navigating complex neurological conditions like MS, cardiovascular health and weight management are critical. Excess weight and cardiometabolic diseases are known to worsen MS clinical outcomes.
Yet, this study highlights a severe care-coordination gap in the US healthcare system. When patients transition between specialized neurologists and primary care doctors, metabolic health can easily fall through the cracks. Because of high brand-name drug prices and strict insurance rules, many chronic illness patients find themselves locked out of treatment. This has driven a massive surge in patients turning to online telehealth platforms to secure affordable, alternative weight-loss care.
What the data says
The research, led by co-author Dr. Ruth Ann Marrie of Dalhousie University and published by The American Journal of Managed Care, analyzed survey data from 4,181 eligible participants in the NARCOMS Registry.
The data highlights a significant treatment gap:
- 40.4% of the MS patients surveyed met official FDA criteria for a GLP-1 prescription (such as Wegovy for obesity or Ozempic for type 2 diabetes).
- Only 14.6% of those eligible patients had ever used a GLP-1 drug.
- Overall, just 7.4% of all MS patients surveyed had ever taken a GLP-1, compared to roughly 12% of the general US adult population.
- Among the small group of MS patients who did access GLP-1s, cardiometabolic disease was highly concentrated: 45.6% had diabetes (compared to 6.5% of non-users) and 57.8% were obese (compared to 24% of non-users).
The study also revealed potential disparities in who actually gets these medications. GLP-1 users in the study were typically younger, employed, had a shorter duration of MS, and were more likely to have relapsing-remitting MS.
From a safety standpoint, the researchers noted that gastrointestinal issues are a primary concern for MS patients taking GLP-1s, as bowel dysfunction is already a common baseline symptom of multiple sclerosis.
How it compares
For US buyers, the massive gap between needing a GLP-1 and actually getting one usually comes down to cost and insurance coverage. Brand-name GLP-1 medications are notoriously expensive:
- Wegovy (semaglutide) carries a list price of roughly $1,349 per month.
- Zepbound (tirzepatide) costs about $1,060 per month without coverage.
Even if an MS patient meets the strict FDA clinical guidelines for obesity (a BMI of 30 or higher, or 27 with a comorbidity), commercial insurance providers frequently deny coverage for weight-loss medications. This forces patients to pay thousands of dollars out of pocket or seek alternative routes.
To bypass these financial barriers, many patients are turning to online GLP-1 telehealth providers and compounding pharmacies. By using clinical platforms to compare rates and services, buyers can often find compounded semaglutide or tirzepatide starting between $200 and $400 per month. These programs bypass traditional insurance requirements, making therapy accessible to those who do not have coverage for brand-name drugs.
How this fits the bigger picture
The severe lack of GLP-1 utilization among MS patients fits into a broader national trend where insurance barriers prevent eligible Americans from receiving care. This trend is especially visible as employers cut GLP-1 coverage over soaring costs, driving cash-paying patients to seek telehealth alternatives.
Furthermore, public insurance programs offer uneven support; while Medicare has historically banned weight-loss coverage, it recently took steps to cover Wegovy for specific cardiovascular risks, and some seniors will benefit when Medicare launches a $50 copay cap for weight-loss GLP-1s in July 2026. However, because these programs still feature strict eligibility rules, millions of patients with overlapping chronic illnesses are left searching for affordable alternatives on their own.
What happens next
To bridge this treatment gap, researchers are calling for prospective, MS-specific studies to evaluate the precise benefits, gastrointestinal risks, and overall safety profile of GLP-1s in patients with neurological conditions. Dr. Marrie emphasized that raising awareness of cardiometabolic health is essential, and better care coordination between neurologists and primary care physicians will be key to helping eligible patients access these treatments safely.
Disclaimer: CompareRx does not provide medical advice. Always consult with your physician or neurologist before starting any new medication, especially if you have a pre-existing neurological condition like multiple sclerosis.