The Impact of GLP-1 and GLP-1/GIP Medications on Weight Management and Employer Costs
The landscape of weight management medications has evolved rapidly, particularly with the introduction of GLP-1 receptor agonists and GLP-1/GIP dual agonists. For employers and plan sponsors, understanding the implications of these medications is crucial for developing comprehensive strategies that support employee health and manage costs effectively.
Overview of GLP-1 and GLP-1/GIP Medications
Glucagon-like peptide-1 (GLP-1) is a naturally occurring hormone that plays a key role in regulating blood sugar levels. Synthetic versions of this hormone have been developed into medications that act on the GLP-1 receptor. Notable examples include Saxenda (liraglutide), Victoza (liraglutide), Wegovy (semaglutide), Ozempic (semaglutide), Trulicity (dulaglutide), Byetta (exenatide), and Bydureon Bcise (exenatide extended-release) . Initially approved for Type 2 Diabetes Mellitus, these medications are now also recognized for their efficacy in managing obesity by slowing gastric emptying and reducing food intake .
Recently, a newer class of medications—GLP-1/GIP dual agonists—has emerged. These drugs target both the GLP-1 receptor and the glucagon-dependent insulinotropic peptide (GIP), which further aids in insulin secretion and reduces glucagon secretion, enhancing weight management. Zepbound (tirzepatide) and Mounjaro (tirzepatide) are examples of these dual agonists .
FDA Approval and Effectiveness
Currently, only three medications—Saxenda (liraglutide), Wegovy (semaglutide), and Zepbound (tirzepatide)—have received FDA approval specifically for weight management. Although all GLP-1 and GLP-1/GIP medications can contribute to weight loss, these three are particularly recognized for this purpose.
The effectiveness of these medications is well-documented. For instance, studies have shown that approximately 33% of patients using Wegovy achieved a ≥20% weight reduction with a once-weekly 2.4 mg injection . Saxenda has been shown to produce a weight loss of 4-6 kg, with a higher proportion of patients achieving 5-10% weight loss compared to placebo . Tirzepatide, on the other hand, has demonstrated significant reductions in BMI, waist circumference, and body weight, with 25% of patients achieving ≥20% weight loss compared to placebo .
These outcomes highlight the potential of these medications to meet weight loss goals, making them an attractive option for employers aiming to improve workforce health.
Financial Impact on Employers
The increasing use of GLP-1 and GLP-1/GIP medications could have substantial financial implications for employers. While 90% of employers provide coverage for these medications in the context of Type 2 Diabetes Mellitus, only 30% offer coverage for obesity management . This gap often stems from the misconception that obesity is a lifestyle choice rather than a chronic condition, leading to off-label use of these medications and inconsistent coverage policies.
The annual cost of these medications can range from $11,000 to $16,000 per member . Given the high cost and growing interest in these treatments, employers must adopt comprehensive strategies to manage these expenses.
Strategies for Managing Medication Costs
To mitigate the financial impact, employers should implement robust strategies that go beyond short-sighted or limited approaches. A comprehensive prior authorization (PA) policy with Pharmacy Benefit Managers (PBMs) is essential to ensure these medications are prescribed appropriately. Additionally, step therapy and quantity limits can contribute to significant cost savings. Step therapy requires patients to try lower-cost alternatives before moving to more expensive treatments, while quantity limits help prevent overuse.
Before implementing these policies, it’s critical for employers to conduct a population-specific analysis. This analysis should focus on current patient demographics and the potential demand for weight management medications. By understanding the health status and needs of their workforce, employers can better predict future medication utilization and identify risks associated with poor weight management, such as increased healthcare costs due to comorbidities.
Staying Updated on New Indications and Emerging Treatments
In the rapidly evolving field of weight management medications, staying informed about new indications and emerging treatments is vital. The market is constantly introducing new formulations, many of which combine GLP-1s with other entero-pancreatic hormones to enhance their efficacy for weight loss and related conditions, such as cardiovascular health and metabolic dysfunction.
Employers must be proactive in monitoring clinical evidence and FDA approvals to anticipate changes in medication usage and associated costs. Regularly reviewing and updating formulary options based on the latest research will help employers provide effective and cost-efficient care for their employees.
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At Axum Rx, we continuously monitor the pipeline for emerging therapies, ensuring that our clients stay ahead with population-specific, evidence-based management strategies. We focus not only on short-term savings but also on long-term risk management. Contact us to learn more about our tailored approach to pipeline management.
References
National Institute of Diabetes and Digestive and Kidney Diseases. (2024). Prescription medications to treat overweight & obesity. National Institutes of Health. Link
Latif W, Lambrinos KJ, Patel P, et al. Compare and Contrast the Glucagon-Like Peptide-1 Receptor Agonists (GLP1RAs) [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: Link
Farzam K, Patel P. Tirzepatide. [Updated 2024 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: Link
Bennett, S. I., & Singh, S. (2024). Cardiac outcomes in patients with chronic kidney disease. The American Journal of Cardiology, 205, 123-130. Link
Mehta, A et al. “Liraglutide for weight management: a critical review of the evidence.” Obesity science & practice vol. 3,1 (2017): 3-14. doi:10.1002/osp4.84
Cai, Wenting et al. “Tirzepatide as a novel effective and safe strategy for treating obesity: a systematic review and meta-analysis of randomized controlled trials.” Frontiers in public health vol. 12 1277113. 31 Jan. 2024, Link
PSG Consults. (2024). 2024 trends in benefit design report. Accessed July 25, 2024. Link
Klausen, M. K., Thomsen, M., Wortwein, G., & Fink-Jensen, A. (2022). The role of glucagon-like peptide 1 (GLP-1) in addictive disorders. British journal of pharmacology, 179(4), 625–641. Link