3 key takeaways from the latest Wegovy trial   

By  Regina Lohr and Gabriela Marmolejos 

These results reveal the potential of second-generation weight management medications to reduce the risk of chronic diseases. Here are our three biggest takeaways:

1. These findings aren't surprising

Earlier studies have already shown that semaglutide offers cardiovascular risk reduction benefits, including declines in blood pressure, total cholesterol, and triglycerides.

Novo Nordisk's other GLP-1 agonist medication, Victoza (liraglutide), is also already FDA-approved for cardiovascular risk reduction as it demonstrated a 13% major adverse cardiovascular events (MACE) risk reduction compared to placebo in the LEADER trial among adults with type 2 diabetes. However, the SELECT trial demonstrated these benefits among patients without diabetes.

2. We need more details on the trial's design

More details are needed on the SELECT trial's design to better understand how Wegovy's cardiovascular risk reduction compares to other approaches like bariatric surgery, which is known to significantly reduce the risk of MACE. One key factor will be the trial's inclusion criteria and discontinuation rates. We don't yet know if patients who discontinued the medication across the course of the trial were included in the trial data or if the data only included patients who stayed on the medication across the full trial.

In the real world, discontinuation is likely to be a key challenge in achieving these kinds of outcomes with weight loss drugs. Our research found that there are many reasons why patients may not maintain adherence to second-generation medications, such as prohibitive costs and unpleasant side effects.

Tune in to our upcoming diabetes and obesity market trends presentation, where we'll discuss these factors in more detail.

3. These results could pave the way for better reimbursement for second-generation medications

Novo Nordisk's announcement states that it is planning to pursue an expanded FDA indication for Wegovy, as they did with Victoza. This move wouldn't necessarily expand the number of people eligible to receive the medication, as the trial was among people who would, in most cases, already be eligible to use Wegovy for chronic weight management under the existing FDA indication. Still, this could change the perception of Wegovy as a "vanity drug" among payers.

Wegovy and other weight loss medications are not currently eligible for reimbursement from traditional Medicare. This expanded indication could enable traditional Medicare coverage of Wegovy among overweight or obese adults with established cardiovascular disease. And if CMS begins to cover Wegovy under traditional Medicare, other payers will likely follow suit.