Preparing your plan for the GLP-1 era
Drug pipeline continues to expand
45 GLP-1/GIPs drugs indicated for obesity are in the pipeline
Weight loss drugs are expected to grow exponentially over the next 3 years. In 2023, GLP-1s represented 63% of diabetes spend, up from 38% in 2020.1 The promising outcomes of these drugs have prompted other manufacturers to pursue their own development efforts.
Drugs expected to treat more than obesity
Previously approved GLP-1s used for other cardiovascular areas
Just as important as the wave of new drugs for obesity is the expansion into other therapeutic areas. Recent clinical trials have examined treatment for sleep apnea, Alzheimer’s and kidney, heart and liver disease. Usage of this class will only expand in the coming years.
Plan sponsors need a strategic partner
Strategies are needed to balance cost, utilization and more
Given the complex and evolving nature of this class, plan sponsors need a strategic partner to help balance cost and utilization. In 2023, plan sponsors who implemented key Optum Rx management strategies saw GLP-1s contribute 50% less towards overall trend growth than for those who didn’t.2
To dig deeper on the history and future implications of this drug class, check out this white paper.
What employers need to know
Balancing GLP-1s cost and coverage
In a recent Optum Rx survey, employers said they are largely accepting of GLP-1s use for diabetes and weight loss, but some felt unprepared for the surge in usage. Most employers agree that offering coverage of these drugs is important for employee retention.
What physicians are saying
Navigating barriers to patient access to GLP-1s
In a recent Optum Rx survey, 77% of physicians said they had prescribed a GLP-1 in the past year, while 93% said they expect to prescribe more GLP-1s for weight loss going forward. While physicians are excited to have an effective tool for patients struggling with obesity, many are concerned with the long-term use of these drugs, noting side effects and cost are top reasons for patients who discontinue treatment.
Key benefits
With an increased demand for GLP-1s, plan sponsors need an innovative weight management solution to reduce costs and improve outcomes.
Appropriate utilization
Plans have the option to cover the most at-risk obesity populations only. Guide members to achieve and sustain their weight loss goals with clinical programs designed to support responsible use of GLP-1 drugs.
Enhanced system edits
Control utilization so anti-obesity medications are only used by those who meet the criteria defined by the plan.
Member support programs
Help permanently change the behaviors contributing to obesity through behavioral support, personalized diets and exercise.
Provider guidance
Obesity specialist physicians determine an individualized weight loss plan for each member and connects them with a weight loss care team.
Strategize about anti-obesity drugs
Learn how our weight management strategies can help your organization. Contact your Optum Rx representative or complete our online form.
Related healthcare insights
Article
After revolutionizing care for diabetes and weight loss, GLP-1 drugs are being eyed for more. Can we afford it?
White paper
The pricey weight management drugs work well, but users need coaching and support to maintain the benefits.
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Balancing anti-obesity drug costs with the benefits
Weight loss can mean better health and lower costs for plan sponsors and members alike. Investing in these expensive, but effective drugs is a balancing act – especially when more than half of the U.S. adult population is eligible for them.
Complementary solutions
Lowering pharmacy benefit costs
Driving pharmacy innovations
Making pharmacy benefits clear
- Internal analysis of Optum Rx Commercial Benchmark BOB 2020 – 2023.
- Internal analysis of 2023 results comparing highly managed clients and Commercial BOB.