Prime Study Finds Lower Adherence, Higher Costs for Weight Loss Drugs | AMCP 2024

Only about one third of patients taking the GLP-1 weight loss drugs continued with the medication one year later, according to new analysis from a real-world integrated pharmacy and medical claims data by Prime Therapeutics/MagellanRx Management. Additionally, just 27% of members were adherent to their GLP-1 therapy for weight loss at one year.

The Prime/MRx real-world findings focused on commercially insured individuals with an obesity medical claim diagnosis without diabetes. The initial results were first released last year. This year, Prime/MRx officials are releasing new analysis at AMCP 2024, the annual meeting of the Academy of Managed Care Pharmacy in New Orleans.

Prime Therapeutics and MagellanRx analyzed integrated pharmacy and medical claims for newly initiated prescriptions for GLP-1a for calendar year 2021. They analyzed data from 4,066 adults who started on Ozempic, Wegovy or Saxenda. In this analysis, the highest persistency rate at one year was 47% for Ozepmic (semaglutide), which is FDA-approved to treat people with diabetes. The lowest persistency at one year was 19% for Saxenda (liraglutide), which is FDA-approved for weight loss. Persistency for Wegovy, the semaglutide product approved for weight loss, was 36%.

Median time to discontinuation ranged from 279 days for patients taking Ozempic to 120 days for patients taking Saxenda.

Scott Leslie

“Although we were unable identify the reason(s) individuals discontinued their GLP-1 therapy, some potential explanations may include semaglutide (Ozempic and Wegovy) shortages and/or adverse effects,” lead author Scott Leslie, director of health outcomes, Prime Therapeutics/MagellanRx Management, told Managed Healthcare Executive.

The study’s authors suggested that a weight loss treatment program, including a care manager, may improve persistency. But they said more research was needed to understand the reasons for treatment discontinuation.

Leslie said these findings suggest that weight loss care management programs should have an adherence and persistency focus. He pointed out that with Wegovy’s prescribing information states that is should be used in combination with a reduced calorie diet and increased physical activity to reduce the risk of major adverse cardiovascular events.

A separate analysis of this real-world study assessed changes in total cost of care one year before and one year after the initiation of GLP-1 treatment for obesity. Researchers found that the mean total cost of care for the GLP-1-treated patients increased from $12,776 to $19,931, a $7,155 (56.0%) increase, and for controls from $11,369 to $11,391, a $22 (0.2%) increase.

Additionally, the GLP-1 treatment group was associated with an increased medical cost that rose from $9,950 to $10,960, (10.1%) increase, and for controls from $9,294 to $8,818, a $476 (5.1%) decrease. There was no medical cost offset.

These findings also indicate that short-term total cost of care should not be expected from GLP-1 weight loss treatment, and instead GLP-1 weight loss treatment should be thought of as a long-term investment with yet unknown, long-term cost-effectiveness.

“These findings highlight the need for GLP-1 weight loss pharmaceutical manufacturers to offer value-based purchasing agreements where manufacturers stand behind their efficacy and persistency clinical trial findings,” Leslie said.

One limitation the researchers note is that pharmaceutical manufacturer rebates and coupons were not included in the cost determination, which could have led overestimated pharmacy costs.