Roel van den Akker: The Shift from High-Growth to High-Volume GLP-1 Commercialization

In the second part of his interview with Pharmaceutical Commerce, Roel van den Akker, Deals partner at PwC, discusses the rapid scaling of GLP-1 treatments, and how the industry might adjust to their growing popularity.

As GLP-1 therapies continue their expansion, the conversation is shifting from early commercialization strategy to the realities of scale. According to a November 2025 poll, about 1 in 8 adults, or 12%, reported taking a GLP-1 treatment for weight loss diabetes or another condition.¹ What was once a high-growth category is quickly becoming a high-volume one, with patient populations that far exceed those of traditional specialty drugs. That shift is forcing manufacturers to rethink the fundamentals of trade and distribution—moving beyond legacy models to ones capable of supporting sustained, large-scale demand while maintaining quality, compliance, and speed to market.

The pressure is particularly acute across manufacturing and distribution networks. Companies are increasingly exploring new pathways, including more direct-to-patient models, while also turning to strategies like M&A to rapidly build out missing capabilities. At the same time, front-end commercial functions are evolving in parallel, as digital tools, CRM systems, and AI-driven engagement reshape how manufacturers interact with both providers and patients in a high-volume environment.

Layered onto these operational challenges is a complex and evolving payer landscape. As GLP-1s could expand into new indications, including areas like addiction treatment, the question of how value is defined becomes more nuanced. Payers and PBMs may lean on long-term health economic data, weighing total cost-of-care reductions against upfront therapy costs. Over time, as pricing dynamics shift and broader societal impact becomes clearer, coverage is likely to expand—but not without ongoing scrutiny and variation between private and public channels.

Building on themes introduced in Part 1, the second part of van den Akker’s discussion with PC examines what it will take to adapt trade and distribution models for blockbuster-scale demand—and how payer strategies may evolve as GLP-1s move closer to becoming a standard of care across multiple therapeutic areas.

Watch the first part of van den Akker’s interview with PC:

1. How GLP-1s Are Shifting Pharma Commercialization Trends

Reference

1. KFF. Poll: 1 in 8 adults say they are currently taking a GLP-1 drug for weight loss, diabetes or another condition, even as half say the drugs are difficult to afford. Published November 14, 2025. Accessed April 17, 2026. https://www.kff.org/public-opinion/poll-1-in-8-adults-say-they-are-currently-taking-a-glp-1-drug-for-weight-loss-diabetes-or-another-condition-even-as-half-say-the-drugs-are-difficult-to-afford/?utm_source=chatgpt.com