Trending weight-loss drugs could be a waste for Minnesotans’ health plans

The proportion of patients who stop taking popular weight-loss drugs raises concerns for a benefits manager at a Minnesota pharmacy about the cost of prescribing these drugs.

Eagan-based Prime Therapeutics announced study results Wednesday showing that just 32% of patients with obesity or prediabetes were still taking GLP-1a weight-loss drugs a year after being prescribed.

The findings question the cost-effectiveness of injectable drugs like Wegovy and Saxenda, which are widely promoted on social media, said David Lassen, Prime’s chief clinical officer. “GLP-1a drugs and their use for weight loss have taken the healthcare industry by storm, but several issues need to be addressed.”

Prime found that total healthcare spending in 2021 was $7,727 higher for patients who started taking the weight-loss drugs than for a control group of matched patients. Expenditures were $13,218 higher for patients who stayed on the medication year-round.

Subsequent research will show whether these patients’ costs will decrease over time as their weight loss saves them from costly diabetes and heart disease.

The drugs’ powerful weight-loss benefits appear to be reversible, so people who stop taking them after a few months may not improve their health long-term, Lassen said.

“That would mean for 70% of those people this was a waste,” he said.

GLP-1a drugs were first used to treat diabetes because they lowered blood sugar. However, later studies showed that they mimic a hormone that delays gastric emptying and prevents hunger.

Many doctors have touted the drugs as a much-needed new tool to fight the obesity epidemic in the United States. About a third of Minnesota adults are surveyed for being obese, one of the lowest rates in the country. Another third of Minnesota adults are overweight.

dr Robert Gabbay, chief scientific and medical officer for the American Diabetes Association, said in a question-and-answer session on Wednesday that these drugs are causing so much weight loss in studies that they’re “entering the realm of benefits that we have.” .” see with bariatric surgery. Pill forms of the drugs are under development.

Physicians with the University of Kansas Health System also called the drugs “groundbreaking” in an online roundtable Wednesday, but said they’re so effective they could lead to malnutrition or patients becoming sedentary because they’re already losing weight.

“Lifestyle [modification] “It’s still very important from an activity and nutrition perspective, but we need to reposition it in the context of these pharmaceutical agents that are now very, very effective,” said John Jakicic, a weight management researcher at KU.

One concern is that the drugs will be promoted outside of the clinical space in TikTok videos and celebrity endorsements, Lassen said. Prime documented increased spending on the drugs shortly after the social media promotion, he added.

Some posts included tips on how to get cheaper versions of the drugs from sources other than doctors. Lassen said that’s concerning because the drugs gained federal approval through studies in which patients received them along with physician supervision and other weight-loss strategies.

The Prime trial could reveal what happens outside of such a tightly controlled environment, when patients take the drugs with minimal supervision.

“It tells us that while these studies showed results, they might not have been real,” Lassen said.

Interest in the drugs is increasing, but some patients stop taking them because of the cost, the hassle of injecting, stomach problems, or other side effects, said Dr. Richard Bergenstal of the HealthPartners Institute’s International Diabetes Center in St. Louis Park. European regulators recently broadened their investigation into the drug class based on rare reports of patients having suicidal thoughts.

For now, Prime recommends insurers obtain prior approval for these weight-loss drugs before agreeing to pay for them.

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