Obesity is a common, serious and costly disease. Per the Centers for Disease Control and Prevention, the US obesity prevalence was 41.99% in 2017 to March of 2020. As most of us are aware, for the treatment of obesity, lifestyle management is the recommended first line — including diet, exercise and behavioral therapy.

However, if patients do not respond to lifestyle management, medication therapy, devices and surgery can be considered.

Medications for weight loss are not new, however, the effectiveness of newer weight loss medications have formed a new conversation on this topic.

What’s the buzz around weight loss drugs?

The buzz is around a new class of medications for weight loss. This class of medications, the GLP-1’s, were first approved for the treatment of diabetes where they were found to be very effective in lowering hemoglobin A1c while also providing clinically significant weight loss.

This impact on weight loss has led to pharmaceutical manufacturers seeking FDA approval for weight loss indications. In the fall of 2023, Zepbound became the third GLP-1 to be approved for weight loss. However, these drugs have the potential to become budget busters for pharmacy benefit plans.

Research indicates that treatment of obesity with GLP-1s is likely to become a chronic maintenance therapy, similar to the treatment of other chronic conditions like high-blood pressure, high cholesterol and diabetes, — at an annual price tag in excess of $17,000. Patients who discontinue these medications rapidly regain the weight they lost.

How can you respond?

Beyond cost, there are concerns about GLP-1s for weight loss including side effects and long-term outcomes.  At their current price point, the impact on pharmacy spend to self-funded plans will be significant and while weight loss can lead to decreased health care costs, those responsible for pharmacy benefits must weigh the cost.

In late 2023, the long anticipated SELECT trial results were released. While there were some positive benefits for patients without diabetes, there was only a 1.5% lowering of cardiovascular (CV) events for those patients who had experienced a previous CV event.

In fact, to prevent one non-fatal heart attack, it would require treating 67 patients for three years, which equates to nearly $2 million in spend.

As the pipeline continues to grow, and demand for medication therapy for weight loss continues, you need the right pharmacy benefit consultant. They must understand the complete clinical landscape of GLP-1s, how to hold your PBM accountable and how to support member care in a sustainable manner.

At Innovative Rx Strategies our team of clinical pharmacists continue to monitor trends, the latest evidence, and pipeline to ensure you are provided the clinical support needed to make the best decisions for your plan.

Download the briefing below for a summary of the current landscape of GLP-1s for weight loss, as well as our recommendations based on current clinical outcomes and cost-effectiveness.

 

Download the Briefing on Weight Loss Drugs

Download

Behind the Curtain: GLP-1s

Dive deeper on weight loss drugs with a pharmacist-led webinar.