State of The GLP-1 Union

A letter from the sister of On The Pen, AKA, employee 001.

Original posted at obesity.news/ on Nov 13th, 2025

You usually hear from Dave Knapp but today you’ve got me, Ann Metz, Dave’s sister and On The Pen employee 001. I’ve been working with Dave part-time for the last year and it’s been rewarding and a lot of fun. I’ve been passionate about health for the last 15 years, learning what I can about how to live a healthy and balance life but for me, that rarely overlapped with prescription drugs or the healthcare arena. However, I did often read health based research, as my degree in psychology equipped me for writing and analyzing scientific studies. This ground work made it easy to connect the dots and ignited my passion for obesity care and the outsized impact that it is having on our healthcare system, quality of life, and human longevity.

I am excited to get to know more of you in the OTP community!

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Dave, our mom—Wendy (maybe the true employee 001) and I at Obesity Week ‘24.

What Dave covered in his latest “State of the GLP-1 Union”

In his recent video, Dave walks through what’s changing right now: the tug-of-war between the big manufacturers, how coverage might shift, and what it could mean for patients deciding between branded and compounded options. He frames the week’s headlines in plain English—where prices might land under the new national deal being discussed, what timelines and coverage guardrails to expect, and why your plan and pharmacy still matter in the short run. It’s practical: he connects the news directly to the questions patients should bring to their next visit.

For context on the headlines he’s reacting to: national outlets reported a White House-brokered agreement with Lilly and Novo that aims to lower list prices for GLP-1s and expand public-program coverage, with press accounts and the White House outlining potential cash prices and Medicare copays and hinting at staged reductions over time; details and timing are still evolving, but this is a massive policy moment for patients, one that Dave and the OTP community have long been fighting for.

It’s been wild to watch doctors look to him for breaking news—from manufacturers, from new studies, from the agencies. He checks primary sources, he verifies, he posts. He isn’t trying to be the loudest; he’s trying to be accurate so regular people can walk into their doctor’s office and “have more confident, competent conversations.”

There’s a home front to this story, too. His wife, Jennie, has had her own long battle getting necessary rheumatoid arthritis medications. Watching them go through prior authorizations, costs, delays, and the relentlessness of it all has taught me about the complexity and painful aspects of the system. It made it clear to me that it’s on all of us to learn how this works and to listen to people who are living it.

I’m proud of Dave—of his work, his sacrifice, and his drive to help people. I’m proud of Jennie’s steady support. I’m proud of our family for learning in public to impact change, when it would’ve been easier to go quiet. And I’m grateful for you, the people who listen, who ask better questions, and who take those questions to their doctors. That’s what this has always been about, making sure people have the words and the confidence to get real care, not just quick advice.

If you’re new here, this is what I’ve seen: my brother taking a hard story and turning it into something useful. Not perfect. Not perfectly polished. Useful. And that matters.

Thanks for being here with us on this journey, we wouldn’t be here without you.

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