Managing the Costs of GLP-1s
As the weight loss effects of glucagon-like peptide-1 receptor agonists (GLP-1s) prescribed for diabetes became apparent, manufacturers pursued new formulations and indication approvals for GLP-1s to treat obesity. The market potential is clear: Experts predict that 1 in 2 adults will be obese by 2030.https://www.nejm.org/doi/full/10.1056/NEJMsa1909301 Further, the United States has seen increased spend on obesity-related illnesses,America's Obesity Crisis: The Health and Economic Costs of Excess Weight. Milken Institute, Oct. 2018. resulting in increased demand for weight loss solutions. The weight management industry is expected to reach $250 billion in sales by 2032.Future Market Insights Global and Consulting Pvt. Ltd. (2022, July 12). Weight management market is expected to garner US$ 725.6 billion, at a CAGR of 7.7% from 2022 to 2032 - future Market Insights, inc.. GlobeNewswire News Room. Retrieved August 4, 2022, from https://www.globenewswire.com/en/news-release/2022/07/12/2478371/0/en/Weight-Management-Market-is-expected-to-garner-US-725-6-Billion-at-a-CAGR-of-7-7-from-2022-to-2032-Future-Market-Insights-Inc.html
Pharmaceuticals account for a significant portion of the market. Since the first GLP-1 received FDA approval for chronic weight management in 2014 (liraglutide, sold under the brand name Saxenda),https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772342/ demand for these drugs has increased exponentially. Within CVS Caremark’s commercial book of business, PMPM spend on GLP-1s increased 102 percent year over year from 2021 to 2022.
While addressing obesity can result in improved health and increased medical cost savings for the health care system, the costs of GLP-1s are significant. Wegovy, the Novo Nordisk variation of blockbuster diabetes drug Ozempic, costs approximately $16,000 per year. If every U.S. adult with obesity received a GLP-1 prescription, the total cost would top $1.2 trillion annually.https://gisthealthcare.com/how-glp-1-agonist-drugs-could-change-healthcare-demand/
Plan sponsors have a range of management options for this class of drugs, depending on their philosophy and goals. Our recommended strategies for our clients are informed by a deep understanding of their member populations, advanced analytics, and effective cost/care levers to deliver an integrated experience.
Our levers decrease net cost, ensure appropriate coverage while preventing off-label use, and maximize clinical effectiveness through personalized support and nutrition for sustainable health outcomes.
As plan sponsors seek to achieve the right balance of access and coverage to meet their business needs, we are committed to providing the most up-to-date guidance to inform those decisions. On this page, you will find a collection of our latest thinking about the drugs in this class and effective strategies to manage them. Please visit frequently for updates.
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