Weight-management drugs are big news for healthcare and mainstream media outlets alike, though the articles don’t always get it right. Are these drugs an end to the obesity epidemic or a dangerous vanity fad? We’ll be diving into the headlines and further discussing weight-management drugs at our Clinical Innovation Summit on August 22-23 in Minneapolis (check out the agenda and register for the summit here). And if you can’t make it, look out for more Advisory Board research and discussions on weight-management drugs in the coming months.

Until then, here are three headlines alongside Advisory Board’s take on what healthcare leaders really need to know.

Headline 1: “New drugs could spell an end to the world’s obesity epidemic”

– The Economist

Advisory Board’s Take: Not likely

GLP-1 receptor agonists (GLP-1s) are a class of drugs that can cause dramatic weight reductions, leading many to believe that they can bring an end to the obesity epidemic. The catch is that people don’t often stay on the drugs long-term, and most individuals taking the medications experience weight re-gain, along with the return of other metabolic outcomes, after discontinuation. These drugs only work when patients are on them, and there are many factors limiting their long-term use including cost and coverage, side effects, and lack of a maintenance dose for those who reach goal weight.

Plans and providers are experimenting with strategies, including obesity centers of excellence, to support those who want to maintain a lower weight after stopping the medications. These methods are still experimental, time will tell which are cost effective and gain the support of plans. Until there are more widespread and effective systems to support weight maintenance, it is unlikely that GLP-1s will perform better than lose-weight-quick methods of the past.

Headline 2: “New Obesity Drug Would Cost Medicare $27 Billion, Even With Limited Uptake”

– Bloomberg

Advisory Board’s Take: Fears are real, but cost estimates are likely inflated

According to the CDC, over 40% of adults in the United States are obese and another 30% are considered overweight. That population size, combined with a hefty list price of $1,350 per month for Wegovy (currently the only GLP-1 approved for weight loss alone), has purchasers and economists concerned. However, market dynamics are likely to limit both the short-term and long-term spending.

Short Term: Right now, many commercial payers and pharmacy benefit managers (PBMs) that cover the drugs are limiting their exposure to these costs by implementing utilization restrictions that are narrower than the FDA indication and requiring patients to try and fail on other drugs before utilizing GLP-1s. These strategies ultimately lead to fewer patients receiving these drugs. Other payers do not cover these drugs for weight loss at all. For example, some employers see use of GLP-1s for weight loss as vanity drugs and exclude them from coverage, while Medicare, by law, is not permitted to pay for weight loss medications.

Long Term: There is a robust pipeline for weight loss medications. As competition increases and supply chain blockers improve, PBMs will have increased power to drive down net costs.  

Headline 3: “The dangers of the Ozempic craze”

– The Week

Advisory Board’s Take: Some risks, but not all, will be managed with time

GLP-1s were originally developed as a treatment for Type 2 diabetes and have since been approved for weight loss. Since the expanded approval, consumer demand for these drugs has skyrocketed, contributing to supply chain shortages. Individuals who rely on the drugs for diabetes or weight loss are having a hard time finding it. Those who are in poorer health or have limited access to clinicians that can help them navigate the supply shortages will suffer the most from the restrictions.  

The supply chain issue is one of many factors limiting access. Differences in payer coverage policies and the drug’s high list prices also contribute to limited access and may exacerbate health disparities. Some barriers to access will dissipate as more competition emerges, prices decrease, and coverage expands. It is likely that these drugs will become more integrated into our existing healthcare paradigms – especially for those who need them most.

Weight bias in the healthcare system is something market dynamics can’t fix. Clinical guidelines emphasize the need to address race-based weight stigma within the clinician community. Adhering to clinical guidelines is critical to ensuring nondiscriminatory treatment for overweight and obese patients. As these products integrate into the health system, providers need more training for weight and obesity management.

What’s next?

At the upcoming Clinical Innovation Summit, our researchers and attendees will be grappling together with what these drugs mean for health care moving forward. In the meantime, we’d like to hear from you – submit a request to speak with our research team about your organization’s strategy on weight loss medications or where you are running into challenges supporting the patients that you work with.