New — The Peptide Dictionary: 128 terms, explained simply
New guide — NAD+ for Anti-Aging: What the Science Says
New guide — GHK-Cu: the copper peptide for your skin
Not sure where to start? — A 60-second quiz points you to the path that fits your goal
New explainer — Semaglutide: what the research says, made simple
Browse — Peptide guides, made simple
New — The Peptide Dictionary: 128 terms, explained simply
New guide — NAD+ for Anti-Aging: What the Science Says
New guide — GHK-Cu: the copper peptide for your skin
Not sure where to start? — A 60-second quiz points you to the path that fits your goal
New explainer — Semaglutide: what the research says, made simple
Browse — Peptide guides, made simple
Skip to main content
Tools

Weight Loss

Start here: GLP-1s for weight loss →

GLP-1 medications, what they cost, and living with them.

Get startedCompare providers27 telehealth providers, scored the same way — price, what's included, and who each one suits.See the comparison →

Sexual Health

Start here: sexual wellness →

ED, low desire, and what the approved options actually are.

Get startedCompare providersSexual wellness providers scored on the same footing — price, format and what's actually included.See the comparison →

Hair Loss

Start here: hair thinning →

Why hair thins, and what has evidence behind it.

Get startedWhat actually worksSix copper peptide serums compared on formula, strength and price.See the comparison →

Hormones

Start here: hormones and aging →

Growth hormone, PCOS, and the peptides people ask about.

Get startedWhat the trials showEvery peptide we cover, with the human trials behind it — or the absence of them.Browse the evidence →

Peptides & Longevity

Start here: what are peptides? →

The molecules, the evidence, and where regulation stands.

Get startedOriginal researchOur own analysis of primary government data — full methodology and datasets published.See the research →

Medications

Start here: every molecule we cover →

One page per medicine — what it is, what it costs, what to expect.

Get startedPeptides A–ZEvery peptide we cover, in one list, with where each one stands.Browse A–Z →
Compare providers
Easy-to-follow guides
Independent reviews
Vetted providers
Free to read

Home / Research / GLP-1 Treatment Gap Index

Medicaid · GLP-1 medications · 50 states + DC

GLP-1 Treatment Gap Index 2026: where Medicaid access falls short of need

We compared every state's adult obesity and diabetes rates with how many GLP-1 prescriptions its Medicaid program actually filled in 2025. The states with the most need are often the ones filling the fewest.

Data: CMS State Drug Utilization Data, CY2025CDC BRFSS 2024-2025Medicaid enrollment reports, 2025

Key findings

#1

Arkansas has the widest GLP-1 treatment gap in the U.S. It ranks 6th for need (37.8% adult obesity, 14.8% diabetes) but last for access: 59 GLP-1 prescriptions per 1,000 adult Medicaid enrollees in 2025, against a national rate of 274.

8.8×

Access varies almost ninefold between states. Pennsylvania Medicaid filled 520 GLP-1 prescriptions per 1,000 adult enrollees; Arkansas filled 59. Across states, need and access are essentially unrelated (correlation r = 0.02).

8/10

Eight of the ten widest gaps are in the South: Arkansas, West Virginia, Georgia, Alabama, South Carolina, Mississippi, Texas and Tennessee. Six of the ten states that have not expanded Medicaid rank in the top eight.

2.1×

Weight-management brands mark the dividing line. In the 12 states where Wegovy®, Zepbound® or Saxenda® made up at least 40% of GLP-1 fills, Medicaid filled 407 GLP-1 prescriptions per 1,000 adult enrollees. In the 34 states where they made up under 10%, it filled 191.

11.2M

Medicaid filled 11.2 million GLP-1 prescriptions in 2025, up 34% from 8.3 million in 2024. Gross spending before manufacturer rebates reached about 12.0 billion USD. GLP-1s were about 1.6% of all Medicaid prescriptions.

3

The gap is likely to widen in 2026. California, Pennsylvania and New Hampshire, three of the 11 highest-access states, ended Medicaid coverage of GLP-1s for obesity after October 2025, as did South Carolina (KFF).

The gap, state by state

Darker states have a wider gap between need and Medicaid access. Index runs from 0 (smallest gap, Massachusetts) to 100 (widest gap, Arkansas). Hover a state for its numbers, or see the full ranking below.

Smallest gapSmall gapModerate gapWide gapWidest gap
Gap index 0 to 100, where 100 is the widest gap between need and access.
Alaska: rank 39 of 51, gap index 40.3, 171 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesAlaska Alabama: rank 4 of 51, gap index 81.9, 263 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesAlabama Arkansas: rank 1 of 51, gap index 100.0, 59 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesArkansas Arizona: rank 13 of 51, gap index 74.2, 93 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesArizona California: rank 50 of 51, gap index 11.5, 369 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesCalifornia Colorado: rank 44 of 51, gap index 29.3, 181 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesColorado Connecticut: rank 43 of 51, gap index 34.4, 317 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesConnecticut District of Columbia: rank 48 of 51, gap index 25.9, 170 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesWashington, DC Delaware: rank 38 of 51, gap index 40.8, 408 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesDelaware Florida: rank 17 of 51, gap index 68.5, 103 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesFlorida Georgia: rank 3 of 51, gap index 84.5, 106 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesGeorgia Hawaii: rank 35 of 51, gap index 41.9, 126 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesHawaii Iowa: rank 25 of 51, gap index 60.8, 262 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesIowa Idaho: rank 40 of 51, gap index 40.2, 284 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesIdaho Illinois: rank 21 of 51, gap index 64.4, 167 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesIllinois Indiana: rank 9 of 51, gap index 77.6, 213 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesIndiana Kansas: rank 29 of 51, gap index 52.0, 396 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesKansas Kentucky: rank 11 of 51, gap index 76.1, 370 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesKentucky Louisiana: rank 14 of 51, gap index 73.5, 299 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesLouisiana Massachusetts: rank 51 of 51, gap index 0.0, 432 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesMassachusetts Maryland: rank 24 of 51, gap index 62.3, 197 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesMaryland Maine: rank 28 of 51, gap index 52.3, 206 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesMaine Michigan: rank 41 of 51, gap index 39.9, 423 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesMichigan Minnesota: rank 47 of 51, gap index 26.5, 410 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesMinnesota Missouri: rank 42 of 51, gap index 39.7, 420 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesMissouri Mississippi: rank 6 of 51, gap index 79.0, 306 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesMississippi Montana: rank 33 of 51, gap index 47.3, 186 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesMontana North Carolina: rank 36 of 51, gap index 41.8, 336 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesNorth Carolina North Dakota: rank 10 of 51, gap index 76.6, 106 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesNorth Dakota Nebraska: rank 18 of 51, gap index 66.1, 225 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesNebraska New Hampshire: rank 45 of 51, gap index 29.2, 366 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesNew Hampshire New Jersey: rank 31 of 51, gap index 48.8, 172 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesNew Jersey New Mexico: rank 19 of 51, gap index 66.1, 168 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesNew Mexico Nevada: rank 16 of 51, gap index 72.5, 166 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesNevada New York: rank 30 of 51, gap index 51.8, 199 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesNew York Ohio: rank 20 of 51, gap index 65.5, 268 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesOhio Oklahoma: rank 12 of 51, gap index 75.8, 174 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesOklahoma Oregon: rank 15 of 51, gap index 73.3, 87 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesOregon Pennsylvania: rank 49 of 51, gap index 25.1, 520 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesPennsylvania Rhode Island: rank 32 of 51, gap index 48.0, 249 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesRhode Island South Carolina: rank 5 of 51, gap index 79.6, 163 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesSouth Carolina South Dakota: rank 26 of 51, gap index 58.9, 256 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesSouth Dakota Tennessee: rank 8 of 51, gap index 78.9, 232 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesTennessee Texas: rank 7 of 51, gap index 79.0, 175 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesTexas Utah: rank 34 of 51, gap index 46.7, 168 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesUtah Virginia: rank 23 of 51, gap index 62.9, 250 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesVirginia Vermont: rank 37 of 51, gap index 41.6, 178 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesVermont Washington: rank 27 of 51, gap index 56.6, 114 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesWashington Wisconsin: rank 46 of 51, gap index 27.8, 501 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesWisconsin West Virginia: rank 2 of 51, gap index 84.9, 315 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesWest Virginia Wyoming: rank 22 of 51, gap index 63.7, 117 GLP-1 prescriptions per 1,000 adult Medicaid enrolleesWyoming

Need doesn't predict access

Each dot is a state. States further right have higher adult obesity rates; states higher up fill more GLP-1 prescriptions per Medicaid adult. If access followed need, the dots would climb from left to right. They don't.

010020030040050060024%27%30%33%36%39%42%Adult obesity rate →GLP-1 Rx per 1,000 adult Medicaid enrolleesU.S. rate: 274Kentucky: rank 11 of 51, 38.0% adult obesity, 370 prescriptions per 1,000 adult Medicaid enrolleesOklahoma: rank 12 of 51, 37.4% adult obesity, 174 prescriptions per 1,000 adult Medicaid enrolleesArizona: rank 13 of 51, 32.8% adult obesity, 93 prescriptions per 1,000 adult Medicaid enrolleesLouisiana: rank 14 of 51, 37.4% adult obesity, 299 prescriptions per 1,000 adult Medicaid enrolleesOregon: rank 15 of 51, 33.1% adult obesity, 87 prescriptions per 1,000 adult Medicaid enrolleesNevada: rank 16 of 51, 34.2% adult obesity, 166 prescriptions per 1,000 adult Medicaid enrolleesFlorida: rank 17 of 51, 29.8% adult obesity, 103 prescriptions per 1,000 adult Medicaid enrolleesNebraska: rank 18 of 51, 36.8% adult obesity, 225 prescriptions per 1,000 adult Medicaid enrolleesNew Mexico: rank 19 of 51, 34.9% adult obesity, 168 prescriptions per 1,000 adult Medicaid enrolleesOhio: rank 20 of 51, 36.4% adult obesity, 268 prescriptions per 1,000 adult Medicaid enrolleesIllinois: rank 21 of 51, 33.9% adult obesity, 167 prescriptions per 1,000 adult Medicaid enrolleesWyoming: rank 22 of 51, 32.6% adult obesity, 117 prescriptions per 1,000 adult Medicaid enrolleesVirginia: rank 23 of 51, 33.3% adult obesity, 250 prescriptions per 1,000 adult Medicaid enrolleesMaryland: rank 24 of 51, 32.9% adult obesity, 197 prescriptions per 1,000 adult Medicaid enrolleesIowa: rank 25 of 51, 36.8% adult obesity, 262 prescriptions per 1,000 adult Medicaid enrolleesSouth Dakota: rank 26 of 51, 35.7% adult obesity, 256 prescriptions per 1,000 adult Medicaid enrolleesWashington: rank 27 of 51, 31.2% adult obesity, 114 prescriptions per 1,000 adult Medicaid enrolleesMaine: rank 28 of 51, 33.1% adult obesity, 206 prescriptions per 1,000 adult Medicaid enrolleesKansas: rank 29 of 51, 37.4% adult obesity, 396 prescriptions per 1,000 adult Medicaid enrolleesNew York: rank 30 of 51, 29.0% adult obesity, 199 prescriptions per 1,000 adult Medicaid enrolleesNew Jersey: rank 31 of 51, 27.3% adult obesity, 172 prescriptions per 1,000 adult Medicaid enrolleesRhode Island: rank 32 of 51, 31.2% adult obesity, 249 prescriptions per 1,000 adult Medicaid enrolleesMontana: rank 33 of 51, 30.6% adult obesity, 186 prescriptions per 1,000 adult Medicaid enrolleesUtah: rank 34 of 51, 30.4% adult obesity, 168 prescriptions per 1,000 adult Medicaid enrolleesHawaii: rank 35 of 51, 26.7% adult obesity, 126 prescriptions per 1,000 adult Medicaid enrolleesNorth Carolina: rank 36 of 51, 34.0% adult obesity, 336 prescriptions per 1,000 adult Medicaid enrolleesVermont: rank 37 of 51, 29.0% adult obesity, 178 prescriptions per 1,000 adult Medicaid enrolleesDelaware: rank 38 of 51, 36.5% adult obesity, 408 prescriptions per 1,000 adult Medicaid enrolleesAlaska: rank 39 of 51, 33.5% adult obesity, 171 prescriptions per 1,000 adult Medicaid enrolleesIdaho: rank 40 of 51, 32.6% adult obesity, 284 prescriptions per 1,000 adult Medicaid enrolleesMichigan: rank 41 of 51, 35.6% adult obesity, 423 prescriptions per 1,000 adult Medicaid enrolleesMissouri: rank 42 of 51, 35.6% adult obesity, 420 prescriptions per 1,000 adult Medicaid enrolleesConnecticut: rank 43 of 51, 31.2% adult obesity, 317 prescriptions per 1,000 adult Medicaid enrolleesColorado: rank 44 of 51, 25.3% adult obesity, 181 prescriptions per 1,000 adult Medicaid enrolleesNew Hampshire: rank 45 of 51, 31.3% adult obesity, 366 prescriptions per 1,000 adult Medicaid enrolleesWisconsin: rank 46 of 51, 37.0% adult obesity, 501 prescriptions per 1,000 adult Medicaid enrolleesMinnesota: rank 47 of 51, 32.7% adult obesity, 410 prescriptions per 1,000 adult Medicaid enrolleesDistrict of Columbia: rank 48 of 51, 24.8% adult obesity, 170 prescriptions per 1,000 adult Medicaid enrolleesPennsylvania: rank 49 of 51, 33.9% adult obesity, 520 prescriptions per 1,000 adult Medicaid enrolleesCalifornia: rank 50 of 51, 29.1% adult obesity, 369 prescriptions per 1,000 adult Medicaid enrolleesMassachusetts: rank 51 of 51, 27.0% adult obesity, 432 prescriptions per 1,000 adult Medicaid enrolleesArkansas: rank 1 of 51, 37.8% adult obesity, 59 prescriptions per 1,000 adult Medicaid enrolleesWest Virginia: rank 2 of 51, 39.4% adult obesity, 315 prescriptions per 1,000 adult Medicaid enrolleesGeorgia: rank 3 of 51, 35.6% adult obesity, 106 prescriptions per 1,000 adult Medicaid enrolleesAlabama: rank 4 of 51, 39.3% adult obesity, 263 prescriptions per 1,000 adult Medicaid enrolleesSouth Carolina: rank 5 of 51, 35.5% adult obesity, 163 prescriptions per 1,000 adult Medicaid enrolleesMississippi: rank 6 of 51, 40.4% adult obesity, 306 prescriptions per 1,000 adult Medicaid enrolleesTexas: rank 7 of 51, 35.9% adult obesity, 175 prescriptions per 1,000 adult Medicaid enrolleesTennessee: rank 8 of 51, 37.9% adult obesity, 232 prescriptions per 1,000 adult Medicaid enrolleesIndiana: rank 9 of 51, 38.0% adult obesity, 213 prescriptions per 1,000 adult Medicaid enrolleesNorth Dakota: rank 10 of 51, 38.0% adult obesity, 106 prescriptions per 1,000 adult Medicaid enrolleesArkansasPennsylvaniaMassachusettsWest VirginiaMississippiGeorgiaWisconsinCaliforniaKentucky

Highlighted: the 10 states with the widest treatment gap. Obesity: CDC BRFSS adult prevalence, 2024-2025 average. Prescriptions: CMS State Drug Utilization Data, CY2025, per 1,000 adults enrolled in Medicaid (2025 monthly average).

Full ranking: all 50 states and DC

Rank 1 is the widest gap. States are listed widest gap first.

Rank State Gap index
(0-100)		 Adult
obesity		 Adult
diabetes		 Rx / 1,000
enrollees		 Rx / 1,000
Medicaid Rx		 GLP-1 Rx
2025		 Change
vs 2024		 Wt-mgmt
share
1Arkansas100.037.8%14.8%594.424,039+27.3%0.8%
2West Virginia84.939.4%17.5%31512.994,999+2.4%0.3%
3GeorgiaNon-exp.84.535.6%12.9%1064.359,374+10.8%2.6%
4AlabamaNon-exp.81.939.3%15.3%26311.271,831+7.6%2.0%
5South CarolinaNon-exp.79.635.5%14.2%1638.865,093+11.4%17.4%
6MississippiNon-exp.79.040.4%15.2%30612.661,646+49.8%52.3%
7TexasNon-exp.79.035.9%13.3%1756.5172,353+16.4%2.9%
8TennesseeNon-exp.78.937.9%14.7%23211.1136,023+46.1%29.9%
9Indiana77.638.0%13.8%21310.5190,162-4.4%4.6%
10North Dakota76.638.0%10.3%1066.45,852+5.7%0.0%
11Kentucky76.138.0%16.1%37010.1274,538+12.2%1.2%
12Oklahoma75.837.4%12.9%17410.382,365+20.0%0.8%
13Arizona74.232.8%12.3%936.693,551+5.4%0.9%
14Louisiana73.537.4%15.4%29912.9230,359-14.9%0.9%
15Oregon73.333.1%11.8%876.572,793+26.9%6.3%
16Nevada72.534.2%13.6%16610.270,939+29.0%1.7%
17FloridaNon-exp.68.529.8%12.6%1036.3133,482+1.6%0.9%
18Nebraska66.136.8%11.4%2259.437,335+7.7%1.3%
19New Mexico66.134.9%12.3%16812.264,832+13.2%0.2%
20Ohio65.536.4%12.9%26811.4425,258+15.5%2.5%
21Illinois64.433.9%12.6%16712.8288,522+8.9%1.1%
22WyomingNon-exp.63.732.6%10.1%1176.22,315-3.7%6.0%
23Virginia62.933.3%13.4%25010.8227,568+2.1%19.7%
24Maryland62.332.9%12.3%19710.1148,648+10.3%2.1%
25Iowa60.836.8%11.4%26211.588,518+26.5%6.9%
26South Dakota58.935.7%11.5%25611.715,602+32.5%0.0%
27Washington56.631.2%9.9%1149.0111,125+7.9%3.1%
28Maine52.333.1%11.3%20614.741,655+22.2%4.2%
29KansasNon-exp.52.037.4%12.6%39615.650,903+59.2%65.1%
30New York51.829.0%12.2%19911.4816,616+15.8%0.0%
31New Jersey48.827.3%10.9%1728.3165,667+20.9%6.2%
32Rhode Island48.031.2%11.8%24914.046,691+27.3%27.2%
33Montana47.330.6%9.0%1868.422,719+1.7%0.8%
34Utah46.730.4%8.6%1688.328,007+25.4%0.5%
35Hawaii41.926.7%11.4%12616.830,478-34.3%0.8%
36North Carolina41.834.0%12.9%33622.1484,712+114.7%47.1%
37Vermont41.629.0%9.4%17811.917,163+21.2%7.0%
38Delaware40.836.5%13.3%40824.255,674+38.6%56.8%
39Alaska40.333.5%8.8%17118.923,249-7.4%5.6%
40Idaho40.232.6%9.1%28412.145,954-2.4%5.0%
41Michigan39.935.6%13.0%42321.7608,028+52.9%59.1%
42Missouri39.735.6%11.7%42018.0285,105+120.6%44.1%
43Connecticut34.431.2%11.3%31719.3174,553-18.4%3.1%
44Colorado29.325.3%8.6%18112.6123,012+60.4%11.6%
45New Hampshire29.231.3%10.1%36617.134,652+56.8%56.8%
46WisconsinNon-exp.27.837.0%11.6%50124.7302,645+50.0%58.5%
47Minnesota26.532.7%10.2%41019.3230,594+39.3%54.0%
48District of Columbia25.924.8%8.8%17015.627,754-7.7%1.9%
49Pennsylvania25.133.9%13.1%52025.2844,001+47.0%54.0%
50California11.529.1%12.6%36934.63,090,441+61.6%55.4%
51Massachusetts0.027.0%9.8%43227.9399,030+56.8%54.5%

"Non-exp." marks states that had not expanded Medicaid as of 2025. Weight-management brand share = Wegovy®, Zepbound® and Saxenda® as a share of all GLP-1 prescriptions filled.

Methodology

Need score

The average of two standardized (z-score) measures from the CDC Behavioral Risk Factor Surveillance System: adult obesity prevalence (BMI 30 or higher) and adult diagnosed diabetes prevalence. We averaged 2024 and 2025. Where a state has only one year published, we used that year (2024 only: California, Mississippi, Nevada; 2025 only: Tennessee).

Access score

The average of two standardized measures from CMS State Drug Utilization Data for calendar year 2025, fee-for-service and managed care combined:

  • GLP-1 prescriptions per 1,000 adults enrolled in Medicaid (2025 monthly average, final reports)
  • GLP-1 prescriptions per 1,000 total Medicaid prescriptions, which corrects for differences in how completely states report pharmacy data

Gap index

Need score minus access score, rescaled so the smallest gap is 0 and the widest is 100.

gap = z(need) − z(access) index = 100 × (gap − min) ÷ (max − min)

Drugs included

Every GLP-1 receptor agonist in the data: Ozempic®, Rybelsus®, Wegovy® (injection and oral), Mounjaro®, Zepbound®, Trulicity®, Victoza®, Saxenda®, generic liraglutide, Byetta®, Bydureon® BCise, Soliqua and Xultophy. Mounjaro® and Zepbound® act on both GIP and GLP-1 receptors.

Limitations

  • CMS suppresses counts under 11 per drug package per quarter, so small states are slightly undercounted.
  • Drugs for people with both Medicare and Medicaid are paid by Medicare Part D and are not in this data.
  • Spending is gross, before manufacturer rebates.
  • Obesity and diabetes rates cover all adults in a state, not only Medicaid enrollees.
  • Q1 2026 data is excluded because several states had not finished reporting.

Updates

CMS releases State Drug Utilization Data quarterly. We refresh the index when a full new calendar year is available and note mid-year changes in coverage.

Frequently asked questions

What is the GLP-1 Treatment Gap Index?

It is a state ranking from Peptides.io that compares how common obesity and diabetes are among adults in each state with how many GLP-1 prescriptions that state's Medicaid program filled in 2025. A high score means high need and low Medicaid access. The index runs from 0 (Massachusetts, smallest gap) to 100 (Arkansas, widest gap).

Which state has the largest GLP-1 treatment gap?

Arkansas. It has the 6th-highest combined obesity and diabetes burden in the country, but its Medicaid program filled 59 GLP-1 prescriptions per 1,000 adult enrollees in 2025, the lowest rate of any state and about one-fifth of the national rate of 274.

How many GLP-1 prescriptions did Medicaid fill in 2025?

About 11.2 million across all 50 states and DC, up 34% from about 8.3 million in 2024, based on CMS State Drug Utilization Data. Gross spending before manufacturer rebates was about 12.0 billion USD.

Does Medicaid cover GLP-1 drugs for weight loss?

It depends on the state. Medicaid programs generally cover GLP-1s for type 2 diabetes. Coverage for obesity is optional: KFF counted 13 state programs covering GLP-1s for obesity under fee-for-service as of January 2026. California, New Hampshire, Pennsylvania and South Carolina ended obesity coverage after October 2025.

Why does Medicaid GLP-1 access vary so much between states?

The biggest driver in the data is whether a state covers GLP-1s for weight management. States where Wegovy®, Zepbound® or Saxenda® made up at least 40% of GLP-1 fills filled about twice as many GLP-1 prescriptions per adult enrollee as states where they made up under 10%. Prior authorization rules, preferred drug lists and Medicaid expansion status also differ by state.

How often is this index updated?

CMS publishes State Drug Utilization Data quarterly. We update the index when a full calendar year of data is available and note coverage changes between updates.

Use this data

Journalists and researchers may use and republish these findings and charts with a link to this page.

Suggested citation
Peptides.io Research (2026). GLP-1 Treatment Gap Index 2026. Analysis of CMS State Drug Utilization Data (CY2025), CDC BRFSS (2024-2025) and CMS Medicaid enrollment data. https://peptides.io/research/glp-1-treatment-gap-index

Sources

  1. Centers for Medicare & Medicaid Services. State Drug Utilization Data 2025 (updated July 2026) and 2024.
  2. Centers for Disease Control and Prevention. BRFSS Prevalence Data, 2024 and 2025.
  3. Centers for Medicare & Medicaid Services. State Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Data, September 2026 release.
  4. KFF. Medicaid Coverage of and Spending on GLP-1s.
© 2026 Peptides.io Research. This report is for information only and is not medical advice.