Weight-loss medications were very much in the news this year, and the pages and website of Managed Healthcare Executive were no exception. Articles on off-label use of the GLP-1s such as Ozempic (semaglutide) and the FDA approval of Zepbound (tirzepatide) garnered the most page views.
They are the trendy way to lose weight, and payers have been noticing an increase in GLP-1 claims. An analysis of the pharmacy and healthcare claims of a small commercial health plan in Texas documents the growth in the off-label usage of the GLP-1s, such as Ozempic, for weight loss.
Insurers are using prior authorization and other managed care strategies to control costs associated with the growing number of prescriptions, on- and off-label, for the weight-loss medications.
Patients with heart failure and obesity who were administered semaglutide experienced better results — they reported fewer symptoms, felt less physically limited, lost more weight, and could walk longer in a 6-minute test.
Tirzepatide, with the brand name Zepbound, is expected to be available by the end of the year in six doses at a list price of $1,059.87, which is about 20% lower than semaglutide.
The Minnesota-based pharmacy benefit manager says a program that resulted in patients switching from two incretin therapy prescriptions to one yielded $7,500 in savings per patient and a total of $3.5 million.
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
Listen
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
Phase 3 Trial of Vertex’s Islet Cell Therapy for Type 1 Diabetes Under Way
April 23rd 2025Zimislecel is an allogeneic stem cell-derived islet cell therapy that could eliminate the need for insulin in those who have type 1 diabetes. Regulatory submissions are expected in 2026, and if approved, would be the second cell therapy for type 1 diabetes.
Read More