4 in 5 health plan execs are significantly concerned about rising GLP-1 utilization and costs, according to a newly released survey from Virta Health.
The survey captures the latest sentiment on GLP-1s from 80 Chief Medical Officers, Chief Pharmacy Officers and actuarial leaders from major national and regional insurers.
Majority of execs expect rapid GLP-1 growth to continue
As demand soars for GLP-1s for weight loss, senior leaders across the country are facing a veritable cost tsunami that could derail future profitability and growth. The majority of respondents expect a 25%+ increase in 2023 alone.
- Diabetes and obesity are the #1 and #2 concerns of health plan leaders in 2023. Due to rising prevalence, skyrocketing pharmacy and ER costs, and downstream health impact, respondents ranked diabetes and obesity above even cancer, cardiovascular disease, musculoskeletal conditions, and mental health.
- 100% of executives are concerned about GLP-1 growth for both diabetes and obesity indications. 70% of health plan leaders cite concerns that current trends will lead to an increase in spend of GLP-1s among members with type 2 diabetes.
- Surging interest in GLP-1s is overwhelming health plans’ ability to manage cost. 80% are concerned about utilization growth. And while 85% of health plan leaders have policies to restrict off-label utilization, they report that these aren’t doing enough to curb prescribing practices.
- To minimize costs, health plan leaders are experimenting with various utilization management strategies. The most popular approaches include provider education on alternatives like lifestyle programs, member communications, and food as medicine programs. Nearly half are also looking at combination and step therapy options.
- Executives want cost containment and proven lifestyle interventions. While GLP-1s have positive clinical outcomes, they cost $12,000-$15,000 per patient, per year, and need to be taken for life to maintain weight loss. Over one-third of those surveyed are already investing in lifestyle solutions to improve clinical and financial outcomes and satisfy member choice, and now look to these to mitigate GLP-1 costs as well.
Survey sheds light on obesity care options beyond GLP-1s
Survey respondents shed light on the importance of lifestyle interventions and GLP-1 alternatives that can deliver sustainable change. Many individuals with obesity believe their options for weight loss are diet and exercise programs, drugs like GLP-1s, or bariatric surgery.
Traditional diet and exercise programs
While inexpensive, these programs vary in their ability to deliver clinically significant weight loss that is sustainable long term. Traditional diet and exercise programs deliver <5% average weight loss at one year 1 and 95% of dieters regain the weight they lost within 2 years 2.
GLP-1 drugs
In contrast, GLP-1s have good clinical outcomes. However, studies show that 65% of weight lost is regained within one year after patients stop taking medication 3. And Prime Therapeutics has reported adherence concerns, sharing that 68% discontinue Wegovy within the first year 4.
Bariatric surgery
Similarly, bariatric surgery promises significant weight loss. While results tend to be more sustainable, it is incredibly invasive and expensive.
A more sustainable and cost-effective option to GLP-1s
Virta Health’s provider-led clinical weight loss solution offers another option which delivers comparable outcomes to expensive GLP-1s, at a fraction of the cost. Through virtual, provider-led support and personalized nutrition, Virta helps members lose weight rapidly and sustainably—and keep it off—without the need for expensive medications.
Virta offers weight loss on par with GLP-1s, but at a fraction of the cost
Virta’s providers are deprescription experts
Virta does not initiate new starts on GLP-1s for members in their obesity reversal (or weight loss) solution, baring rare, exceptional circumstances. In fact, Virta providers have a proven approach for deprescribing GLP-1s and other medications, while simultaneously helping patients retain much of their weight loss progress:
- As Virta members engage and lose weight, Virta providers monitor changing biomarker data.
- Virta providers monitor health progress and are available to answer medical questions from members and to assess new symptoms related to the program as needed.
- Through shared decision making, Virta providers deprescribe GLP-1s and other cardiometabolic medications when it is safe and clinically appropriate to do so.
The importance of member choice
Members often don’t realize that there is an option like Virta, where you can lose weight and keep it off - without the need for drugs or surgery. It’s imperative to educate patients and providers on the evidence behind the best available weight loss options and help them navigate to the right choice. The positive impact goes beyond clinical and financial outcomes, to support member satisfaction and retention efforts as well.
“The Ozempic helped, but there is no magic bullet out there. I needed to change my diet. The energy level I have now is amazing, I’m walking 6–8 miles a day. My attitude is way better too. I didn’t care about a lot of things before, but now I do.” - Dan, lost 110 pounds with Virta
Click here to get the full survey report.
Click here to learn more about Virta’s obesity reversal solution, a cost effective alternative or offramp to GLP-1s.
About Virta
Virta Health is the leader in type 2 diabetes, obesity and prediabetes reversal. Our virtual approach combines personalized nutrition therapy with continuous provider-led support to empower members to eliminate medications, lose weight, and take back their lives. Virta has earned the trust of the nation’s largest organizations, including Humana, AutoZone, and Blue Shield of California. We also deliver industry-leading cost savings of over $6,000 per member per year while putting our fees at risk based on health outcomes. Learn more: www.virtahealth.com.
Citations
1 Rena R Wing , Suzanne Phelan, Long-term weight loss maintenance, The American Journal of Clinical Nutrition, Volume 82, Issue 1, July 2005, Pages 222S–225S, https://doi.org/10.1093/ajcn/82.1.222S
2 Chin, S., Keum, C., Woo, J. et al. Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity. Sci Rep. 2016; 6, 34563
3 Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564.
4 Real world analysis by Prime Therapeutics. n=4,255. Commercial data from people with obesity, prediabetes, or BMI > 30. Cited in Reuters, “Most patients using weight loss drugs like Wegovy stop within a year.” July 11, 2023