GLP-1 Agonists: The Rapid Rise of Obesity Medications

Ozempic, Mounjaro, and Wegovy are some of the explosively popular GLP-1 drugs making headlines in 2023. GLP-1 stands for Glucagon-like Peptide-1, a hormone released during eating that prompts insulin production and increases feelings of satiety.

GLP-1 Receptor Agonists closely resemble this hormone and are a class of type 2 diabetes drugs. GLP-1 drugs not only improve blood sugar control but also prompted gradual weight loss . ¹  Blood sugar levels rise after eating and GLP-1 medications signal the body to produce more insulin, which helps level off elevated blood sugar levels.

Additional effects of GLP-1 drugs are slowed movement of food from the stomach to the small intestines. Studies have found that all GLP-1 drugs can lead to weight loss of about 10.5 to 15.8 pounds (4.8 to 7.2 kilograms) when using liraglutide (Saxenda) ². Participants using semaglutide (Wegovy/Ozempic) and adding lifestyle changes including moderate exercise lost about 33.7 pounds (15.3 kilograms) compared to 5.7 pounds (2.6 kilograms) for those not taking the drug.

The FDA is slowly approving more drugs to treat obesity (defined as having a BMI of 30 or greater) but the current two approved GLP-1 agents for weight loss only are Wegovy and high-dose Saxenda. The other five brand drugs are Xenical, Alli, Qsymia, Contrave, and Imcvree. Each of these drugs have various barriers that require compounding, potentially severe side effects, or are cost prohibitive .

Additional benefits of certain GLP-1 drugs include preliminary reductions in heart and kidney diseases ⁵. Continuing studies are needed to determine whether the drugs are directly causing these benefits or if these are byproducts of general weight loss but initial results show the potential in combating the multiple conditions that obesity causes.

As Health Plans meet with Benefit Managers to review formulary changes or perform market checks, it’s important to discuss increasing consumer demand for these drugs and discuss expanding coverage. As most GLP-1 medications are brand drugs that are recently new to market, they may be manufacturer rebate eligible.

Health plans and employers are at a crossroads when evaluating coverage for GLP-1s. Here’s a look at some of the crucial factors they need to weigh:

Benefits include:

• Improved Health Outcomes: Weight loss has been associated with reduced risk of heart disease, diabetes, and other chronic conditions.
• Enhanced Quality of Life: Weight loss can lead to increased mobility, improved mental health, and overall well-being.
• Potential Cost Savings: Long-term weight management might reduce healthcare costs associated with obesity-related diseases.

Potential Challenges:

• Cost Concerns: The expense of Wegovy and Ozempic can be a deterrent, especially when considering the potential number of individuals who might benefit.
• Adverse Effects: Gastrointestinal side effects and potential long-term implications require careful assessment.
• Coverage Dilemma: Balancing coverage for chronic conditions like diabetes versus proactive weight management.

As health plans and employers deliberate on coverage, customization emerges as a key theme. Different populations have varying needs, necessitating tailored approaches.

At the core of these coverage deliberations lies the aspiration to enhance patient outcomes and well-being. Health plans and employers can engage in conversations with members or employees to understand their needs and preferences. Empowering individuals with information about these medications allows for shared decision-making.

As research continues to unfold, health plans and employers can adjust coverage strategies based on emerging evidence – shifting societal perspectives on weight and health could further drive the need for comprehensive coverage.

The decision to cover GLP-1s is emblematic of the intricate interplay between healthcare advancements and economic considerations. Health plans and employers are tasked with striking a balance between promoting healthier lifestyles and managing costs.

As we navigate this evolving landscape, it’s evident that customized solutions, patient-centered approaches, and ongoing dialogue will remain at the heart of decisions that have the potential to reshape how we address weight management and its associated health outcome.

Proper Consulting Group provides tailored strategies for navigating these complex pharmacy benefit decisions and can help health plans and employers shape the future of healthcare coverage for these products with nuanced decision making.

Sources:

1. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss
2. GLP-1 agonists: Diabetes drugs and weight loss – Mayo Clinic
3. https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
4. GLP-1 Agonists: What They Are, How They Work & Side Effects (clevelandclinic.org) 
5. https://www.goodrx.com/classes/glp-1-agonists/glp-1-drugs-comparison 

FDA Drug Release Info:

1. Adlyxin: FDA approves Adlyxin to treat type 2 diabetes | FDA
2. Byetta: Drug Approval Package: Byetta (Exenatide) NDA #021773 (fda.gov)
3. Mounjaro: FDA Approves Novel, Dual-Targeted Treatment for Type 2 Diabetes | FDA
4. Ozempic: FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014 | FDA
5. Rybelsus: https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-glp-1-treatment-type-2-diabetes
6. Saxenda: FDA approves weight management drug for patients aged 12 and older | FDA
7. Trulicity: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/125469Orig1s000TOC.cfm
8. Victoza:https://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/022341s000TOC.cfm#:~:text=Approval%20Date%3A%201%2F25%2F2010
9. Wegovy: https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014