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.
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.
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.
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Internal analysis of Optum Rx Commercial Benchmark BOB 2020 – 2023.
Internal analysis of 2023 results comparing highly managed clients and Commercial BOB.