LAS VEGAS—Demand for GLP-1s has not slowed, and employers still have not cracked the code on the perfect solution for medications that represent a growing portion of spend.
Scott Honken, chief commercial officer for WeightWatchers, sorted employers into several key buckets in terms of how they're currently approaching coverage for GLP-1s. First, there are those who have covered these products historically and continue to do so.
Then, there's the group that's looking at avenues for coverage and trying to determine the best ways to maximize investment in coverage and weight management programs. The final group sees these drugs and the associated costs as potentially catastrophic to their pharmacy budgets.
Honken, in an interview with Fierce Healthcare, said WeightWatchers has a number of clients in the second category, and it's encouraging as it means they recognize the need for services around obesity and weight management, and, even if they can't afford to cover GLP-1s today, they want to take steps to support their members.
"You don't want to do nothing, right?" he said. "And so even if you're not investing in the medication, having a program that can serve the needs of a wide variety of individuals is really helpful here."
GLP-1s and all the questions around them were a central topic this week at HLTH 2024. Panels touched on coverage, care management and recent trends of private label compounding that aim to bring down the cost and boost access to these products.
Shantanu Nundy, M.D., chief health officer at Accolade, told Fierce Healthcare in an interview that a lot of firms are in "experimental mode" as they weigh a strategy for metabolic care, allowing trailblazers to establish a path that they may be able to follow.
There are multiple levers employers can consider in how they choose to build a program around obesity. Some have elected to set guardrails around GLP-1s—for instance, limiting them for weight loss to people within certain body mass index windows. Others are looking to partners like WeightWatchers or digital health providers like Noom for more of an end-to-end weight management approach.
Nundy said that where his team is seeing significant potential is around adapting the centers of excellence model to metabolic care. For some patients who may need these services, it may be fairly easy for them to make time for visits to providers, nutritionists or other specialists who are involved in weight management.
There are also populations in which that is far more difficult. By connecting them with a center of excellence, it can "fast track" their access to the doctors they need to see. Accolade is deploying these kinds of services virtually, too, which adds even more convenience, he said.
"If at the end of the tunnel you really want people to achieve the weight loss goals, that actually requires really, really high quality care," he said.
Honken said WeightWatchers has historically taken a similar approach, and weight management is about more than just offering a patient a GLP-1 drug and that's that. These drugs may not be the right fit for every patient, and they may simply not be able to afford them.
Instead, it's building a suite of options around the patient that can meet them where they are, he said. And, in cases where GLP-1s are available, WeightWatchers has a compounded product that it makes available at self-pay prices to members.
"I think that's really the key—having best in class offerings across any of those health profiles, and maybe not exclusively steering people to a GLP-1 one track, which is going to, inevitably, kind of artificially increase costs more than might happen anyway," Honken said.
Nundy said it's also important for clinicians to have honest conversations with patients about these drugs. There are still a lot of unanswered questions about their long-term efficacy and whether there are any significant side effects from long-term use.
They're also injectable drugs, which may turn off some patients on that basis alone, and they require refrigeration and other considerations that may make their use inconvenient for some people. It also remains unclear how long patients may need to take GLP-1s, but it's likely at least for several years, he said.
But it's necessary to balance the side effects of the drugs with how obesity may be impacting a patient's health.
"It's not like, here's something that has some small risk of harm versus something that has no harm," he said. "It's not like you're not having a side effect: You're having one now, just from the condition and not necessarily from the treatment."