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.
Saxenda (liraglutide), the first GLP-1 to be approved for weight loss, was shown in studies to reduce weight by 5.4-7.4% while Wegovy (semaglutide), the second GLP-1 approved for weight loss, was shown to reduce weight by 9.6-16%. Mounjaro (tirzepatide), approved only for treatment of diabetes, has demonstrated very significant weight loss of up to 22.5% body weight. Eli Lilly, the manufacturer of Mounjaro is currently pursuing a weight loss indication from the FDA. We could see approval of this indication as early as the fall of 2023.
Studies have shown that, although GLP-1’s are effective at reducing weight, many patients regain weight when therapy is discontinued. It is this caveat that creates the most concern for long-term cost and outcomes.
Treatment of obesity could now 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
Concerns about new weight loss medications
Concerns about new weight loss medications include side effects, cost and the lack of long-term outcomes. With annual costs exceeding $17,000 and additional products in the pipeline, the impact on pharmacy spend to self-funded plans will be significant. While weight loss can lead to decreased health care costs and improved overall health outcomes, high quality evidence of the long-term impact of weight loss from this new class of medications is pending in adults without diabetes.
As the pipeline continues to grow, and demand for medication therapy for weight loss continues, it is vital to understand what strategies your PBM can deploy to ensure appropriate utilization. Finding the right pharmacy benefit consultant that understands the complete clinical landscape of this emerging area will be paramount.
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.