By Chad Terhune
(Reuters) – Only about one-third of patients prescribed a popular weight-loss drug like Novo Nordisk’s Wegovy were still taking it a year later, while total healthcare costs for the group rose sharply, according to an analysis of U.S. pharmacy claims shared with Reuters.
The annual cost of overall care for patients prior to taking Wegovy or a similar drug was $12,371, on average, according to the analysis. The full-year cost after starting the medication jumped by 59% to $19,657, on average.
The costs for a similar control group of patients not taking the drugs decreased by 4% over the same period. The mean age of patients included in the analysis was 47 and 81% were female.
Medicines such as Wegovy can cost more than $1,000 per month, and any improvement in health and subsequent reduction in medical costs is not likely to occur quickly.
“This analysis points to the fact that there can be a lot of spending on people that are not likely to reap any long-term health benefits,” said Khrysta Baig, a health policy researcher at Vanderbilt University who reviewed the findings for Reuters.
“We need to better target who has access to them if we want to realize their full potential,” she said of the obesity treatments.
Novo Nordisk did not comment on the analysis, but said in a statement that “obesity requires long-term management” and “broadening coverage is key to ensure that those who need (therapy) can access and afford their medicines.”
The analysis by Prime Therapeutics, a pharmacy benefits manager (PBM), reviewed pharmacy and medical claims data for 4,255 people with commercial health plans. They had all received new prescriptions of the drugs from a class known as GLP-1 agonists between January and December 2021, and had a diagnosis of obesity, prediabetes or a body mass index of 30 or higher.
GLP-1 drugs, originally developed to help control blood sugar in patients with type 2 diabetes, also suppress appetite and promote a feeling of fullness.
For the analysis, Prime Therapeutics excluded patients with type 2 diabetes to focus on obesity treatment.
Nearly half of the patients were prescribed Novo’s injected Ozempic or Wegovy, both of which contain the active ingredient semaglutide. Others were taking Saxenda (liraglutide), an older Novo GLP drug, or Rybelsus, an oral version of semaglutide.
Overall, 32% of the patients were still taking the medicine for weight loss a year after their initial prescription. All the patients had insurance coverage for GLP-1 drugs, and the results did not differ materially based which of the drugs was prescribed, Prime said.
Patrick Gleason, Prime’s assistant vice president for health outcomes and a co-author of the analysis, said this real-world data suggests a substantial drop in adherence compared to what was reported in clinical trials. In trials with adults, Novo found that 6.8% of patients taking Wegovy discontinued treatment due to gastrointestinal problems and other adverse events.
“The majority of patients aren’t getting the value of the product and there’s waste, especially with an expensive therapy,” Gleason said. “I was a little bit surprised by the persistency rate.”
Prime Therapeutics is owned by 19 U.S. Blue Cross and Blue Shield health insurance plans and manages pharmacy benefits for about 38 million people.
Prime did not ask patients why their prescriptions stopped. Gleason suggested a mix of possibilities, including patients finding the nausea and vomiting side effects too severe or an inability to afford to keep paying co-pays or deductibles.
Drugmakers and many doctors have been pushing for better insurance coverage of anti-obesity medications. They say employers, insurers and PBMs might be contributing to low adherence by imposing too many restrictions and high out-of-pocket costs.
David Lassen, chief clinical officer at Prime Therapeutics, said it will take two to three years of data to better gauge the financial and medical outcomes for patients taking GLP-1 drugs for obesity. He said a majority of Prime’s commercial customers do not currently cover weight-loss medications.
“This data doesn’t help move them off of that,” Lassen said.
(Reporting by Chad Terhune; Editing by Michele Gershberg and Bill Berkrot)
