Eli Lilly and Novo Nordisk have made at least one payment to more than a quarter of a million individual doctors and other prescribers in the United States, according to an analysis of federal disclosure data published this week by The Washington Post. The payments run through meals, travel, speaking fees, consulting arrangements, and similar services.
None of this is illegal, and all of it is publicly disclosed. That is the point worth holding onto. The federal Open Payments database exists precisely because Congress decided patients should be able to see financial relationships between drug companies and the clinicians who prescribe. What the analysis documents is the scale of that spending in a drug class that has become one of the largest in American medicine.
For a patient sitting in an exam room being told a GLP-1 might help, the relevant question is not whether their doctor has been paid. It is whether they can find out, and what they should ask either way.
Inside the Payment Trail: The Analysis Followed
The analysis of federal payment disclosures drew on Open Payments records for 2018 through 2025, the most recent year available, and on interviews with physicians involved in the manufacturers' marketing programs. It covers general payments, the category that includes meals, travel, speaking fees, and consulting. It describes an approach recognizable from decades of pharmaceutical promotion, adapted to a drug class with unusual reach.
Individual sums can be substantial. Lee Kaplan, a prominent obesity medicine physician quoted in the reporting, was paid about $648,000 by GLP-1 manufacturers between 2018 and 2025. Payments to individual physicians tied to specific drugs have long been visible in public tools, including a payment tracker for individual drugs built from the same federal data.
This is descriptive reporting on disclosed financial relationships, not a regulatory finding. No agency has alleged misconduct, and payments of this kind are lawful when reported. Research on pharmaceutical payments has consistently found an association between receiving payments and increased prescribing of the sponsor's product, but association is not proof that any individual clinician's judgment was changed.
Legal, Disclosed, and Largely Invisible to Patients
The disclosure system has a gap that matters more than the totals. Payments are reported to a federal database that almost no patient has ever opened.
Television advertising for these drugs is impossible to miss. The promotional spending directed at prescribers is far less visible, and it reaches the person who actually writes the prescription. Critics quoted in the reporting argue that physicians serving as paid ambassadors may not give a full and objective picture of the drugs and their side effects.
The stakes are financial as well as clinical. GLP-1 medications are expensive, and coverage varies widely. Medicare began covering some of them for weight management on July 1 through a temporary Medicare coverage program known as the GLP-1 Bridge, which sets a $50 monthly copayment for eligible Part D beneficiaries and is scheduled to run through the end of 2027. Many commercial plans still require documented participation in a supervised weight management program, and some employers have dropped coverage over cost. A prescription that a patient cannot afford to continue is its own kind of harm, since stopping typically means regaining weight.
The Case Paid Physicians Make for These Programs
The physicians involved are not defensive about it, and their argument deserves a fair hearing.
Obesity medicine has been a neglected corner of American healthcare. The American Medical Association recognized obesity as a disease only in 2013, and many practicing clinicians still treat it as a matter of willpower rather than physiology. Kaplan argued that "The medical establishment hasn't stepped up," and that the pharmaceutical industry has been the only party consistently working to give prescribers knowledge about these drugs. He also disputes the premise that the medications are overprescribed, pointing out that only about 11 percent of people with a body mass index above 40 are receiving one.
Physicians in these programs describe their role as helping colleagues overcome hesitancy and outdated assumptions. A physician quoted in the reporting said he had sought funding from the major manufacturers for independent education without success. Lilly and Novo Nordisk did not confirm or discuss that request but said they review all grant requests. Manufacturer competition has intensified as both companies push new oral formulations and prepare for broader coverage, as manufacturer competition ahead of Medicare coverage has shown.
Both things can be true. Prescriber education in a fast-moving field is a genuine need, and industry funding of that education creates a genuine conflict. The disclosure system was built on the assumption that transparency lets patients weigh both.
Looking Up a Prescriber and What to Ask
Anyone can search the federal Open Payments database by physician name and see what payments a manufacturer reported, in what amount, and for what purpose. It takes about a minute. Finding a payment there is not a red flag by itself, since a conference meal and a five-figure speaking contract appear in the same system.
The more useful conversation happens in the appointment. Reasonable questions include what alternatives were considered before this medication, what the expected side effects are and how common, what happens if the drug is stopped, what it will cost after insurance, and whether the clinician has a financial relationship with the manufacturer. Most physicians will answer that last one directly, and the question is not an accusation.
Patients can also ask whether behavioral and dietary treatment has been given a real trial, whether an obesity-related condition is present that changes the calculation, and what the monitoring plan looks like. Nobody should start or stop a prescription based on a news story about marketing spending.
Several questions remain open. The reporting does not establish that payments changed prescribing decisions for any individual patient. It is unclear whether federal regulators intend to examine promotional practices in this drug class. And the effect of manufacturer funding on the professional society guidelines that shape treatment standards is acknowledged as a concern but not quantified.
What readers can act on now is smaller and concrete. Look up a prescriber if you want to. Ask about cost and alternatives regardless. And treat industry-funded patient education material, wherever it appears, as information with a sponsor attached.
Key Questions Answered
What did the analysis find? That Eli Lilly and Novo Nordisk have made at least one payment to more than 250,000 individual US doctors and other prescribers, through meals, travel, speaking fees, and consulting, as GLP-1 sales grew.
Are these payments illegal? No. Payments from manufacturers to clinicians are legal and must be reported to a federal database. The reporting describes disclosed relationships, not alleged misconduct.
Does a payment mean my doctor is biased? Not on its own. Research finds an association between industry payments and increased prescribing of the sponsor's product, but that does not establish that any particular clinician's judgment was affected.
How do I check whether my doctor received payments? Search the federal Open Payments database by name. It lists the manufacturer, amount, date, and stated purpose of reported payments.
What should I ask at an appointment? What alternatives were considered, what side effects to expect, what happens if the drug is stopped, what it will cost after insurance, and whether the clinician has a financial relationship with the manufacturer.
Does this mean GLP-1 drugs do not work? No. This reporting concerns marketing spending, not clinical effectiveness. The medications have substantial trial evidence for weight reduction and for several related conditions.
What are the coverage options if cost is the barrier? A temporary Medicare program covers certain weight management drugs for eligible Part D beneficiaries with a $50 monthly copayment through 2027. Commercial coverage varies, and patients can ask about prior authorization, appeals, and manufacturer direct-pay programs.
