Weight Loss Medications Without a Holistic Approach Invites Discontinuation and Lost Investment for Employers
DALLAS, May 16, 2024 -- Early discontinuation of medications happens for various reasons – and for the increasingly popular GLP-1 medications, they include supply chain issues, cost and intolerable side effects ranging from nausea and diarrhea to more severe complications like gastroparesis (stomach paralysis), among others. The medications, broadly referred to as "GLP-1 agonists," are used to treat type 2 diabetes or as a co-therapy with diet and exercise for sustained weight loss in people who are overweight or struggling with obesity. Known under their brand names of Wegovy®, Saxenda® and Zepbound™, demand for the medications continue to rise. Growing evidence indicates roughly two-thirds of patients discontinue these expensive medications within one year, and with approximately 75 percent of the total addressable market (TAM) for the GLP-1 pipeline existing within the commercially insured space, this should signal to employers to plan ahead. GLP-1 medications can cost as much as $1,200 per month, and discontinuing treatment can mean lost investment for employers and regained weight for employees. Drug manufacturers' own FDA-approved package insert shows that discontinuing treatment will result in a rapid return of the weight. Employers that already opted to cover the medications saw them quickly rise to their top-five most expensive health plan costs within 90 days of initiating coverage, according to internal Lockton data. J.P. Morgan Research predicts the GLP-1 market will exceed $100 billion by 2030, with roughly 30 million users in the U.S. alone. As more indication approvals happen, coupled with mounting pressure from clinicians and advocacy groups, employer health plan coverage of weight loss medications, for at least some indications, will soon become standard. With almost 50 percent of working-age Americans being obese, the calculus of employers that opted in early on these medications was understandable. They promised a smooth and rapid path to a healthier employee population with fewer chronic conditions, and a reduced healthcare spend. However, evidence to the contrary, including our own, continues to mount. Consider these findings:
Clearly, GLP-1s have transcended fad. Manufacturers are winning expanded uses of the medications from the FDA, which recently granted Wegovy approval as a treatment to reduce subsequent cardiovascular risk among adults without diabetes who are overweight and who previously suffered a major cardiovascular event, including heart attack and stroke. It was the first approval of its kind. Employers not currently covering GLP-1s beyond diabetes treatment should be planning now to ensure responsible utilization and cost-effectiveness when broader coverage is required. To prepare, here are some considerations:
Healthy weight loss is a journey, not a destination. These medications are neither a primary nor a solitary therapy. Lifestyle intervention programs are critical to successful adherence. One without the other will invariably lead to more discontinuation and lost investment for employers. Dr. Shealynn Buck, MD is the Chief Medical Officer for Lockton Companies. Robert Kordella, RPh is Chief Clinical Officer for Lockton Pharmacy Consulting. SOURCE Lockton Dunning |
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