FILE – Drugs known as GLP-1 receptor agonists, including Ozempic, can be used effectively to … [+]
Only 15% of patients prescribed GLP-1 for weight loss were still taking the drugs two years later, according to an analysis of pharmacy claims published July 10 by pharmacy benefit manager Prime Therapeutics. A slew of other recently published studies show relatively high rates of patients dropping out as early as four weeks after treatment, and that dropout increases over time. Evidence that many people may stop using obesity drugs shortly after starting treatment casts doubt on the sustainability of weight loss in achieving long-term positive health outcomes.
There is a high demand for obesity drugs known as glucagon-like peptide-1 or GLP-1 agonists. Combined with an appropriate diet and exercise regimen, GLP-1s can provide significant health benefits to patients. These are not limited to weight loss. GLP-1s have been used for nearly two decades in the treatment of type 2 diabetes. And a GLP-1 named Wegovy secured a additional cardiovascular indication by the Food and Drug Administration this spring.
Drugs are also being studied in late stages of clinical development for chronic kidney disease and non-alcoholic fatty liver diseasewhere they have shown promise.
To achieve these health benefits, however, it is critical that individuals prescribed GLP-1s continue to take them at least long enough to achieve clinical success, and preferably longer to avoid potential weight regain once off medicines.
PBM Prime Therapeutics published a news analysis on July 10, showing that only about 15 percent of people who started taking GLP-1 drugs for weight loss persisted after two years.
Endpoints News References that PBM conducted an insurance claims analysis of 3,364 obese patients (body mass index greater than 30) who were initiated on GLP-1 during 2021 and were continuously enrolled in a commercial insurance company. Patients with diabetes were excluded from the study.
Only 47% of patients were still receiving GLP-1 at 180 days. 29% in one year. and 15% in two years.
The drugs included in the study were Victoza (liraglutide), Saxenda (liraglutide), Ozempic (semaglutide), and Wegovy (semaglutide). Saxenda and Wegovy have FDA-approved weight loss indications. Victoza and Ozempic are FDA-approved for diabetes and can be prescribed off-label for obesity.
Patients taking Ozempic and Wegovy — injected once a week — were more persistent than those taking Victoza and Saxenda. About 24% who used Wegovy were still taking the drug at two years, and 22% were still taking Ozempic.
Only 7% of patients prescribed Victoza and Saxenda—a once-daily injection—were taking it after two years.
The Prime Therapeutics study did not look at why patients stopped the drugs. These can range from side effects to supply shortages. It could also be that the patients had achieved their weight goal.
However, in a separate study published by The Blue Cross Blue Shield Association last month, 58% of patients stopped use before reaching a clinically significant level of weight loss. Specifically, more than 30% of patients stopped treatment after the first month.
Also, a peer-reviewed study published earlier this year by the research journal Portliness indicates that only 40% of obese patients taking semaglutide-based GLP-1 products were persistent at one year. And another dietary study was released earlier this year from Journal of Managed Care & Specialty Pharmacy revealed that 72% of people who started taking GLP-1 for obesity were no longer taking them after one year.
These findings pose challenges for insurers and employers making decisions about whether to cover the drugs. If patients discontinue treatment, this can lead to weight regain and ultimately wasted resources, not only for the patient but also for the payer. Wegovy and similar drugs are listed at more than $1,000 a month, NBC News notesand may require extensive use to produce significant benefits.
Recent overview conducted in late May of this year shows that only 34% of United States employer health plans offer coverage of GLP-1 drugs for both diabetes management and weight loss.
The lead author of the latest study — Patrick Gleason, Assistant Vice President, Health Outcomes at Prime Therapeutics — said in an interview with Endpoint News that real-world data underscore the need for health plans to ensure patients receive comprehensive care, such as case and disease management programs aimed at behavior modification.
Citing limitations in the study, Novo Nordisk, which makes the drugs included in the claims analysis, said in a statement mentionted with Reuters that he “does not believe these data are sufficient to draw conclusions about overall patient compliance and persistence with various GLP-1 drugs, including our treatments.”
However, the problem of patient nonadherence to GLP-1 under real-world conditions, reviewed and published by an increasing number of sources, does not disappear. It should be addressed extensively by multiple stakeholders in order to improve the chances of achieving sustainable positive health outcomes for people trying to lose weight.
