New Treatments for Obesity: Managing Costs & Care
Key Learnings:
DHNY convened industry experts to discuss a topic on everyone’s mind: Rising interest in obesity treatments.
Analysis from Max Karpman at Valued Pharmacy Services shows a 90% increase in utilization from the first half of 2023 compared to 2022. Much of the rise is GLP-1 agonists, drugs such as Ozempic and Wegovy that are approved and used to treat diabetes by improving blood sugar control and potentially contributing to weight loss.
Karpman says plans could see year-over-year spending increases of 36% on GLP-1 treatments. Some companies are restricting access to drugs for employees in response to the costs, reported in the media as up to $1,400 per treatment per month.
Despite the price tag, plan sponsors need to look at the big picture, says Dr. Mark Cunningham-Hill at Northeast Business Group on Health. “Yes, it’s a large cost for employers, but not covering these drugs isn’t going to solve the problem. Healthcare costs have been rising for 30-plus years.”
Three trends explain increased interest. One is media attention. The second is the acute need: In New York City alone, nearly 60% of adults have overweight. The third is a shift in how society perceives obesity, says Dr. Katherine Saunders at Intellihealth. “Historically, the idea was that it was a lifestyle problem, but now people realize it’s reasonable to treat obesity medically.”
The challenge is that obesity is a chronic condition. Since the average patient has 10 weight-related complications, Saunders says, treatments must be customized. For plan sponsors, Christine Gallagher at STOP Obesity Alliance recommends comprehensive benefits that include behavioral therapy, pharmacotherapy, surgery, and weight maintenance. Without support, the average patient only stays on weight-loss therapies for two months, and 80% regain weight within five years of their initial treatment.
Saunders describes the obesity therapy pipeline as “mind-blowing,” with Eli Lilly’s tirzepatide, poised for FDA approval by year’s end, achieving weight loss approaching 16
