Most US patients stop using Wegovy and Ozempic within two years, claims show
An analysis of pharmacy records also demonstrates a steady decline in use over time
10 July 2024 - 14:41
byChad Terhune
Support our award-winning journalism. The Premium package (digital only) is R30 for the first month and thereafter you pay R129 p/m now ad-free for all subscribers.
Boxes of Ozempic and Wegovy. Picture: Hollie Adams
Only one in four US patients prescribed Novo Nordisk’s Wegovy or Ozempic for weight loss were still taking the popular medications two years later, according to an analysis of US pharmacy claims that also shows a steady decline in use over time.
The analysis does not include details about why patients quit. But it does offer a longer view on the real-world experiences of patients taking the drugs than previous research that studied use over a year or less.
Evidence that many people may stop using the weight-loss therapies not long after starting is influencing a debate over their cost to patients, employers and government health plans.
Wegovy and similar medicines, which belong to a class of drugs known as GLP-1 receptor agonists, can cost more than $1,000 per month, and may require extended use to yield meaningful benefits.
Their US prices have drawn fire recently from President Joe Biden and other public officials, who said such drugs could cost the country $411bn per year if only half of adults with obesity used them. That is $5bn more than Americans spent on all prescription drugs in 2022.
“GLP-1s for all isn’t cost effective,” said Rekha Kumar, an obesity specialist at New York Presbyterian-Weill Cornell Medical Center and chief medical officer at Found, an online weight-loss programme. “People want to provide obesity care to their employees, but they want to do it in a way that doesn’t bankrupt them.”
Prime Therapeutics and Magellan Rx Management, a pharmacy benefits manager (PBM), reviewed pharmacy and medical claims data for 3,364 people with commercial health plans that cover GLP-1 drugs. They had all received new prescriptions between January and December 2021, and had a diagnosis of obesity or a body mass index of 30 or higher.
The PBM excluded patients using the drugs for type 2 diabetes, for which these medicines were originally developed. The mean age of patients included in the analysis was 46.5 and 81% were female.
Last year, Prime published data that found 32% of patients were still taking a GLP-1 medicine for weight loss 12 months after their initial prescription. The new data shows that overall, for all the drugs included in the study, only about 15% were still on their medication after two years.
Fared worse
For Wegovy, 24.1% of patients persisted with therapy over two years without a gap of 60 days or more, down from 36% who had stayed on the drug for a full year. With Ozempic, which has the same active ingredient as Wegovy — semaglutide — 22.2% of patients kept filling their prescriptions at two years, down from 47.1% who had used it for one year.
Older GLP-1 drugs fared worse. At two years, only 7.4% of patients were still taking Novo’s Saxenda, a less effective weight-loss drug that some health plans require patients try before newer GLPs such as Wegovy or Eli Lilly’s Zepbound.
In the analysis, 45% of patients were taking Ozempic or Wegovy. Others were taking Saxenda or Victoza, which are both liraglutide, Rybelsus, an oral version of semaglutide, or Lilly’s Trulicity (dulaglutide).
The analysis also found that 26% of patients switched GLP-1 drugs during therapy, perhaps reflecting shortages or changes in insurance coverage, according to Patrick Gleason, assistant vice-president for health outcomes at Prime/MRx and a co-author of the analysis.
Novo and Lilly have been unable to keep up with unprecedented demand for the new medicines.
Novo Nordisk cited several limitations to the analysis. It noted that Wegovy wasn’t launched until June 2021, the middle of the study period, and wasn’t immediately covered by insurance. And Ozempic isn’t approved for weight loss, which can affect patients’ coverage and persistence with therapy, the Danish drugmaker said.
The company said it “does not believe these data is sufficient to draw conclusions about overall patient adherence and persistence to various GLP-1 medicines, including our treatments”.
Won approval
The newer GLP-1s in clinical trials helped people lose more than 15% of their body weight by suppressing appetite and promoting a feeling of fullness. They are being tested for many other health benefits that could improve insurance coverage.
Wegovy in March won US approval for reducing the risk of strokes and heart attacks in overweight and obese adults.
The analysis didn’t track long-term use of Lilly’s Mounjaro and Zepbound, which launched after the study’s starting point. Eli Lilly declined to comment on the overall findings.
Prime/MRx did not ask patients why their prescriptions stopped. Gleason said it is likely to be a mix of side effects such as nausea and vomiting, out-of-pocket costs not covered by insurance and supply shortages.
Some patients may decide to stop the medication after successfully losing weight, doctors said. Other studies have shown that most patients who quit their GLP-1 drugs usually regain most of the weight.
“No-one really knows how long you should be on these medications,” said Walid Gellad, a professor of medicine at the University of Pittsburgh who studies medication adherence.
Some clinics and telehealth services aren’t screening patients properly or providing adequate coaching on nutrition and exercise alongside the drug, Kumar said, leading to poor results and patients giving up.
Prime/MRx is owned by 19 US Blue Cross and Blue Shield health insurance plans and manages pharmacy benefits for about 38-million people.
David Lassen, the PBM’s chief clinical officer, called the steady drop in persistence two years into therapy concerning.
“It’s not levelling off but getting slightly worse,” he said. “It’s really about sustainability of weight loss to achieve long-term outcomes.”
Support our award-winning journalism. The Premium package (digital only) is R30 for the first month and thereafter you pay R129 p/m now ad-free for all subscribers.
Most US patients stop using Wegovy and Ozempic within two years, claims show
An analysis of pharmacy records also demonstrates a steady decline in use over time
Only one in four US patients prescribed Novo Nordisk’s Wegovy or Ozempic for weight loss were still taking the popular medications two years later, according to an analysis of US pharmacy claims that also shows a steady decline in use over time.
The analysis does not include details about why patients quit. But it does offer a longer view on the real-world experiences of patients taking the drugs than previous research that studied use over a year or less.
Evidence that many people may stop using the weight-loss therapies not long after starting is influencing a debate over their cost to patients, employers and government health plans.
Wegovy and similar medicines, which belong to a class of drugs known as GLP-1 receptor agonists, can cost more than $1,000 per month, and may require extended use to yield meaningful benefits.
Their US prices have drawn fire recently from President Joe Biden and other public officials, who said such drugs could cost the country $411bn per year if only half of adults with obesity used them. That is $5bn more than Americans spent on all prescription drugs in 2022.
“GLP-1s for all isn’t cost effective,” said Rekha Kumar, an obesity specialist at New York Presbyterian-Weill Cornell Medical Center and chief medical officer at Found, an online weight-loss programme. “People want to provide obesity care to their employees, but they want to do it in a way that doesn’t bankrupt them.”
Prime Therapeutics and Magellan Rx Management, a pharmacy benefits manager (PBM), reviewed pharmacy and medical claims data for 3,364 people with commercial health plans that cover GLP-1 drugs. They had all received new prescriptions between January and December 2021, and had a diagnosis of obesity or a body mass index of 30 or higher.
The PBM excluded patients using the drugs for type 2 diabetes, for which these medicines were originally developed. The mean age of patients included in the analysis was 46.5 and 81% were female.
Last year, Prime published data that found 32% of patients were still taking a GLP-1 medicine for weight loss 12 months after their initial prescription. The new data shows that overall, for all the drugs included in the study, only about 15% were still on their medication after two years.
Fared worse
For Wegovy, 24.1% of patients persisted with therapy over two years without a gap of 60 days or more, down from 36% who had stayed on the drug for a full year. With Ozempic, which has the same active ingredient as Wegovy — semaglutide — 22.2% of patients kept filling their prescriptions at two years, down from 47.1% who had used it for one year.
Older GLP-1 drugs fared worse. At two years, only 7.4% of patients were still taking Novo’s Saxenda, a less effective weight-loss drug that some health plans require patients try before newer GLPs such as Wegovy or Eli Lilly’s Zepbound.
In the analysis, 45% of patients were taking Ozempic or Wegovy. Others were taking Saxenda or Victoza, which are both liraglutide, Rybelsus, an oral version of semaglutide, or Lilly’s Trulicity (dulaglutide).
The analysis also found that 26% of patients switched GLP-1 drugs during therapy, perhaps reflecting shortages or changes in insurance coverage, according to Patrick Gleason, assistant vice-president for health outcomes at Prime/MRx and a co-author of the analysis.
Novo and Lilly have been unable to keep up with unprecedented demand for the new medicines.
Novo Nordisk cited several limitations to the analysis. It noted that Wegovy wasn’t launched until June 2021, the middle of the study period, and wasn’t immediately covered by insurance. And Ozempic isn’t approved for weight loss, which can affect patients’ coverage and persistence with therapy, the Danish drugmaker said.
The company said it “does not believe these data is sufficient to draw conclusions about overall patient adherence and persistence to various GLP-1 medicines, including our treatments”.
Won approval
The newer GLP-1s in clinical trials helped people lose more than 15% of their body weight by suppressing appetite and promoting a feeling of fullness. They are being tested for many other health benefits that could improve insurance coverage.
Wegovy in March won US approval for reducing the risk of strokes and heart attacks in overweight and obese adults.
The analysis didn’t track long-term use of Lilly’s Mounjaro and Zepbound, which launched after the study’s starting point. Eli Lilly declined to comment on the overall findings.
Prime/MRx did not ask patients why their prescriptions stopped. Gleason said it is likely to be a mix of side effects such as nausea and vomiting, out-of-pocket costs not covered by insurance and supply shortages.
Some patients may decide to stop the medication after successfully losing weight, doctors said. Other studies have shown that most patients who quit their GLP-1 drugs usually regain most of the weight.
“No-one really knows how long you should be on these medications,” said Walid Gellad, a professor of medicine at the University of Pittsburgh who studies medication adherence.
Some clinics and telehealth services aren’t screening patients properly or providing adequate coaching on nutrition and exercise alongside the drug, Kumar said, leading to poor results and patients giving up.
Prime/MRx is owned by 19 US Blue Cross and Blue Shield health insurance plans and manages pharmacy benefits for about 38-million people.
David Lassen, the PBM’s chief clinical officer, called the steady drop in persistence two years into therapy concerning.
“It’s not levelling off but getting slightly worse,” he said. “It’s really about sustainability of weight loss to achieve long-term outcomes.”
Reuters
Out of pens: How pharma greed cuts people with diabetes off from lifesaving meds
Novo Nordisk and Indonesia’s Bio Farma sign deal to produce insulin
China approves Eli Lilly diabetes drug
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.
Most Read
Related Articles
Out of pens: How pharma greed cuts people with diabetes off from lifesaving meds
China approves Eli Lilly diabetes drug
Runaway obesity drug demand drives Novo Nordisk profit boost
Published by Arena Holdings and distributed with the Financial Mail on the last Thursday of every month except December and January.