Specific weight-loss drugs did not reduce cost of living over two years, data show

Posted by Chad Terhune

(Reuters) – Drugs like Wegovy may reduce your waistline but not medical costs, according to an analysis of US health insurance claims shared with Reuters.

The annual cost of care for US obesity patients two years after they started using Novo Nordisk’s Wegovy or similar GLP-1 drugs was $18,507, on average. That represents a 46% jump over the average annual premium of $12,695 before prescription drugs, data provided by pharmacy benefits manager Prime Therapeutics shows.

Costs for the same control group of untreated patients increased by 14% over the same period.

Among GLP-1 patients, prescription drug costs increased spending, but medical costs also rose over the two-year period.

Over a two-year period, the study found “no reduction in obesity-related medical events,” such as heart attack, stroke and type 2 diabetes diagnosis, or prescription drug use. for high blood pressure and cholesterol, compared to the control group. .

Novo and rival Eli Lilly, maker of the GLP-1 weight-loss drug Zepbound, have reaped billions of dollars in profits since their new drugs hit the US market, with just a fraction of the estimated number of patients 100 million obese people have used it.

They say that the use of their medicine will save money in the society by reducing many health problems related to excess body weight.

However, many US employers and government health officials remain wary of introducing coverage for these highly effective, but expensive, drugs because of the significant future investment and lack certainty about future savings.

Ben Ippolito, an economist at the American Business Institute, said: “The budget here is alarming to many governments and private organizations.” “What makes these drugs different is the magnitude of the potential demand.”

Some analysts have said that the weight loss drug market could reach $150 billion a year in the next decade.

“We know that obesity treatment is linked to better clinical outcomes, although management does not know how to account for these savings,” Novo Nordisk said in a statement. Lilly did not respond to a request for comment.

NOT ‘THE END’

Prime Therapeutics reviewed pharmacy and medical records for 3,046 individuals with commercial health plans that covered GLP-1 drugs. All had received new GLP-1 prescriptions between January and December 2021, and had been diagnosed with obesity or a body mass index of 30 or more.

At the time of the analysis, 46% of patients were taking Novo’s Ozempic or Wegovy, two types of semaglutide injection. Others were using the older drugs Novo Saxenda or Victoza, both of which are liraglutide, Rybelsus, an oral form of semaglutide, or Lilly’s Trulicity (dulaglutide).

The researchers did not track long-term use of Lilly’s new GLP-1 drugs, Mounjaro and Zepbound (both tirzepatide), which began after the study began.

Prime did not include patients who had diabetes in their medical records or who were taking a type 2 diabetes medication, for which the medication was originally designed. The mean age of the patients in the analysis was 46 and 81% were women.

Patrick Gleason, senior vice president for health outcomes at Prime and co-author of the review, said employers and insurers should be prepared to spend an additional $11,200 for each patient who take a GLP-1 medicine for obesity during the first two years of treatment. because of the price and lack of reduction in medical related costs.

The estimate reflects drugmakers’ discounts for these drugs but not all discounts, he said.

In this study, only one in four patients who were prescribed Wegovy or Ozempic for weight loss were still taking the medication two years later, which Reuters reported in July.

David Lassen, the PBM’s vice president for pharmaceutical services, said it can be difficult to replicate the health benefits shown in clinical trials because so few patients adhere to their prescriptions.

“I don’t think it’s completely complete at this point,” Lassen told Reuters, adding that three years of data would be needed to measure the cost impact.

“We want to do everything we can to help people get the best results from taking these medications,” Lassen said. “But if we decide that there is no good result with our data and there is no return on investment, that will be the first point that we will have to consider.”

Prime has 19 Blue Cross and Blue Shield health insurance plans and manages drug benefits for about 38 million people.

The company estimates that less than 20% of members have a prescription for weight loss drugs. Prime said it supports consumers’ decision to cover these GLP-1 drugs along with lifestyle modification programs.

Valerie Smith, associate professor of population health sciences at Duke University, said her research on bariatric surgery also found no reduction in medical costs even when weight loss was maintained over the years. many.

However, he said the test could mask potential savings among certain groups of patients, such as those with severe obesity or multiple chronic conditions.

(Reporting by Chad Terhune; Editing by Bill Berkrot)

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Specific weight-loss drugs did not reduce cost of living over two years, data show

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