The GLP-1 class of medications for diabetes and weight loss is a hot topic right now. However, there is some confusion on their purpose and function:
- What do they cost?
- Should my plan cover them?
- How do I control my plan spend if I cover them?
Semaglutide and Liraglutide
Let’s look at an example with two specific drugs, semaglutide and Iiraglutide.
- Semaglutide is marketed as Ozempic (diabetes only) and Wegovy (weight loss only).
- Liraglutide is marketed as Victoza (diabetes only) and Saxenda (weight loss only).
The GLP1 class of medications has shown to be effective for treating diabetes and weight loss, causing their popularity to skyrocket the last two years. This has caused dramatic increases in pharmacy spend and trend for employers that chose to add GLP1 diabetes and weight loss coverage, about 41% of plans.
- Ozempic and Victoza costs $9,000 to $14,000 per year.
- Wegovy and Saxenda average $18,000 to $22,000 per year.
Impact on Spend in 2023 and Beyond
GLP-1 weight loss medications underperformed in 2022 due to supply chain issues from the two dominant manufacturers, so 2023 should be a better prediction of the spending trends. Analysts predict the weight loss category to be $50B annually by 2030 or 8.8% of outpatient spend. For perspective, the number one selling drug in the United States, Humira, was $20.7B in 2021. Humira accounted for 5% of retail drug spend.
Manage Your Spend
How can you control spend on these medications? At Maxor, we have specific programs that help clients manage diabetic medications and weight loss medications, if covered by their plan. Our utilization management strategies, care improvement program, and clinical analytics help track member adherence and habits and increases in costs and adoption; we help you balance these within your plan.
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