Gaps in glucagon fills among commercially insured patients receiving a glucagon prescription

•Factors influencing glucagon fills with an active prescription are unexplored.•More than one-third of high-risk patients did not fill their glucagon prescription.•A larger study in a diverse population is warranted to assess contributing factors. Glucagon is critically underutilized, and we explored whether this is due to inadequate glucagon prescribing or the patient’s inability to fill prescriptions. Of 216 commercially insured, high-risk individuals with diabetes who were prescribed glucagon in our healthcare system, 142 (65.4%) had a claim indicating its fill within 30 days.