Whether on TV or on public transportation, GLP-1 keeps advertising to lose weight. But are they actually worth the hype?
The question was raised during a panel discussion at the Medcity Invest meeting in Chicago by Harrison Newman, a consulting company co-president. Newman presided over the meeting.
According to one panelist, GLP-1 is very effective in obese patients. But when the drugs are portrayed on social media, the focus is on the “vanity aspect,” said Disha Narang, an endocrinologist and director of obesity medicine. That’s what causes shortages and coverage difficulties, she added, because demand becomes so important.
“Most of my patients have tried everything under to lose weight,” she said. “They aren’t there trying to wear high-end dresses 10 or 15 pounds away from the target. It’s not necessarily the vanity we’re talking about. We talk about metabolic diseases. When I see patients, they have heart disease, liver disease, diabetes.”
She added that GLP-1 has been around for longer than many people realize. GLP-1 has been used to treat diabetes for nearly two decades. Narang added that they also began to obtain regulatory approval for weight management about six to eight years ago. Additionally, side effects are usually gastrointestinal-related, such as stomach upset, indigestion and nausea. She said studies show that about 95% of patients can tolerate the drug.
“We didn’t see long-term complications from it. In fact, we saw long-term benefits.
Another panelist at AJ Loiacono, CEO of pharmacy welfare company Capital RX, noted that if the drugs were priced at reasonable prices, the conversation around GLP-1’s coverage wouldn’t even happen.
He said the strategy to cover GLP-1 depends on the company’s profile. Coverage may not be an issue for wealthy employers, but it is a major challenge for the vast majority of people struggling with the cost trend.
“Based on the data, this drug will certainly be effective,” he said. “But the question is, who pays?”
He added that the average employee cycle is three to four years before moving to the next employer, but the long-term value of GLP-1 may not appear until seven to nine years. In this case, “most people, if you are just doing math, don’t want to cover it up because you will never see the benefits.”
These comments on the cost challenge were Shawn Gremminger, president and CEO of the National Healthcare Buyers Alliance Alliance, an employer’s advocacy group.
“When you talk about things that can greatly increase health care spending, you have to have these conversations. From an employer’s perspective, it feels like now we have to be bad people because drug users and PBMs are greedy and we have to be those who refuse.
Although the high-priced label of GLP-1 has caused some employers to back down, host Newman believes that covering them can actually save employers in other ways.
“The fact that these drugs are working is creating a healthier workforce,” Newman said. “A healthier workforce is a more productive workforce. … When you try to attract and retain, one employer is offering them, another employer is not a huge selling point. You may find ways to provide funding based on increased productivity, improved health, lack of time off, days off, and more.”
Narang agrees, noting that diabetes and obesity lose about $2.4 trillion a year.
However, Gremminger believes that individuals who benefit the most from GLP-1 coverage are generally not employed by companies such as Amazon and Google, which are affordable. Instead, they often work for more closely-business organizations like school districts and manufacturers.
He noted that one strategy that some employers have implemented is a higher body mass index (BMI) threshold for GLP-1 coverage compared to formally approved drugs. Additionally, he stressed the importance of pairing these medications with lifestyle support to help ensure sustainable weight loss.
