July 10,2024
London: Only one in four U.S. patients prescribed Novo Nordisk’s Wegovy or Ozempic for weight loss were still taking the popular medications two years later, according to an analysis of U.S. pharmacy claims provided to Reuters that also showed a steady decline in use over time.
The analysis does not include details about why patients quit. But it does offer a longer view on the real-world experiences of patients taking the drugs than previous research that studied use over a year or less.
Evidence that many people may stop using the weight-loss therapies not long after starting is influencing a debate over their cost to patients, employers and government health plans.
Wegovy and similar medicines, which belong to a class of drugs known as GLP-1 receptor agonists, can cost more than $1,000 per month, and may require extended use to yield meaningful benefits.
Their U.S. prices have drawn fire recently from President Joe Biden and other public officials, who said such drugs could cost the country $411 billion per year if only half of adults with obesity used them. That is $5 billion more than Americans spent on all prescription drugs in 2022.
“GLP-1s for all isn’t cost effective,” said Dr. Rekha Kumar, an obesity specialist at New York Presbyterian-Weill Cornell Medical Center and chief medical officer at Found, an online weight-loss program. “People want to provide obesity care to their employees, but they want to do it in a way that doesn’t bankrupt them.”
Prime Therapeutics and Magellan Rx Management, a pharmacy benefits manager, reviewed pharmacy and medical claims data for 3,364 people with commercial health plans that cover GLP-1 drugs. They had all received new prescriptions between January and December 2021, and had a diagnosis of obesity or a body mass index of 30 or higher.
The PBM excluded patients using the drugs for type 2 diabetes, for which these medicines were originally developed. The mean age of patients included in the analysis was 46.5 and 81 per cent were female.
Last year, Prime published data that found 32 per cent of patients were still taking a GLP-1 medicine for weight loss 12 months after their initial prescription. The new data shows that overall, for all the drugs included in the study, only about 15 per cent were still on their medication after two years.
For Wegovy, 24.1 per cent of patients persisted with therapy over two years without a gap of 60 days or more, down from 36 per cent who had stayed on the drug for a full year. With Ozempic, which has the same active ingredient as Wegovy – semaglutide – 22.2 per cent of patients kept filling their prescriptions at two years, down from 47.1 per cent who had used it for one year.
Older GLP-1 drugs fared worse. At two years, only 7.4 per cent of patients were still taking Novo’s Saxenda, a less effective weight-loss drug that some health plans require patients try before newer GLPs like Wegovy or Eli Lilly’s Zepbound.
In the analysis, 45 per cent of patients were taking Ozempic or Wegovy. Others were taking Saxenda or Victoza, which are both liraglutide, Rybelsus, an oral version of semaglutide, or Lilly’s Trulicity (dulaglutide).
The analysis also found that 26 per cent of patients switched GLP-1 drugs during therapy, perhaps reflecting shortages or changes in insurance coverage, according to Dr. Patrick Gleason, assistant vice president for health outcomes at Prime/MRx and a co-author of the analysis.
Both Novo and Lilly have been unable to keep up with unprecedented demand for the new medicines.
Source: Healthworld