A recent study by Blue Health Intelligence has shown that a significant number of individuals (58%) discontinue using GLP-1 medications within the first twelve weeks of treatment. It also found that 80% cease to receive coverage for these medications twelve months after starting them. The study focused on drugs such as Saxenda (liraglutide) and Wegovy (semaglutide), with Zepbound (tirzepitide) not included as it was unavailable during the study period. The research encompassed a large sample size of 169,250 members who were prescribed GLP-1s for weight loss, all who had continuous health insurance coverage.
The findings suggest that discontinuation often occurred not by choice but due to lack of coverage by health plans or insurance denials. Some members might have found alternative ways to obtain these drugs, such as through drug coupons, compounding pharmacies, importation, or switching to a GLP-1 labeled for diabetes treatment.
Interestingly, the study aligns with previous findings from Prime Therapeutics, which reported that 68% of individuals prescribed GLP-1 medications for obesity discontinued use after one year. This is in stark contrast to clinical research, where discontinuation rates are much lower, ranging from 2% to 14%.
The report also highlighted several factors influencing persistence and adherence to treatment. Higher persistence rates were noted among individuals treated by endocrinologists or weight specialists, those with lower out-of-pocket costs and those experiencing complications from metabolic diseases.
Additional insights from the report include:
Most prescriptions for anti-obesity GLP-1s are issued by primary care providers, due to the insufficient number of specialists in endocrinology or obesity management.
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The New England Journal of Medicine recently reported findings from the FLOW study, which investigated the effects of Ozempic (semaglutide) on diabetics with early-stage kidney disease. The study was halted prematurely last fall after an interim analysis revealed that participants receiving the medication experienced fewer negative outcomes compared to those on a placebo. Conducted across 28 countries, the study involved a diverse cohort of over 3,500 participants, monitored for an average duration of 3.4 years.
Results indicated that semaglutide recipients showed a reduced progression of kidney disease, with a 24% decrease in major first-time kidney events, a 29% reduction in first-time cardiovascular events, an 18% decrease in cardiovascular-related deaths and a 20% reduction in overall mortality. Novo, the drug's manufacturer, has announced plans to seek Food and Drug Administration (FDA) approval for its use specifically in treating diabetic patients with kidney disease.
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The FDA has recently approved two self-collection devices from Roche and BD for testing human papillomavirus (HPV), which is linked to the majority of cervical cancer cases. This advancement suggests that in the future, women might have the option to conduct tests at home, avoiding the need for a pelvic examination typically required for cervical cancer screening. HPV tests, which can be conducted alongside or in place of pap smears, are crucial as pap smears are advised every three years starting at age 21, and HPV tests every five years beginning at age 25.
Currently, the FDA's approval allows for the use of these self-collection devices in a healthcare provider's office, where the collected sample will be sent to a lab for analysis. Approval for home use of these devices is anticipated later this year, with availability expected in the coming months. Importantly, these tests are covered by commercial health insurance plans and Medicare under the same billing codes as provider-collected swabs.
The introduction of HPV vaccines for both girls and boys has significantly decreased cervical cancer rates among young adults. With the addition of self-testing, there's a potential to further drive down these rates, supporting the goal to eliminate cervical cancer by 2030. According to the National Committee on Quality Assurance, 73% of eligible members enrolled in preferred provider organization plans were up to date with cervical cancer screenings in 2022.
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Data released by KFF in May revealed that women who have recently given birth are nearly twice as likely to carry medical debt compared to their counterparts who haven't given birth recently. This conclusion was drawn from a 2022 survey, which indicated that 14.3% of recent mothers had medical debts over $250, in stark contrast to 4.8% of women who hadn't given birth in the past 18 months.
Previous research by KFF highlighted that the additional medical costs for women who delivered averaged $18,865, with out-of-pocket expenses averaging $2,854.
Medicaid programs, which cover nearly half of all childbirths in the U.S. and feature minimal cost-sharing, suggest that the bulk of this medical debt comes from those with commercial insurance. Additionally, some women who hadn't given birth within the last 18 months might still carry leftover medical debt from previous childbirths.
A story covered by KFF Health News in May discussed a couple in Illinois, both educators, who opted out of having a second child due to the $5,000 debt incurred from their first child's delivery.
Childbirth often coincides with financial vulnerability. Individuals may be managing student loan repayments, credit card debt, chronic health conditions, unstable employment, or saving for a home. The financial strain is exacerbated by income loss and increased expenses during this period, making it challenging for many families to afford the substantial out-of-pocket costs associated with childbirth. Moreover, IRS regulations mandate that maternity care expenses must be included in the deductibles of high-deductible health plans (HDHPs) with tax-advantaged health savings accounts (HSAs).
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