Study Reveals Over Half of Patients Stop Weight-Loss Drugs Too Early
More than half of the individuals prescribed weight-loss drugs Saxenda and Wegovy over the past decade did not continue their treatment long enough to gain significant health benefits, according to a study by a major U.S. health insurer.
Key Findings
The Blue Cross Blue Shield Association analyzed pharmacy and medical claims of nearly 170,000 people between July 2014 and December 2023. They discovered that 58% of patients didn’t complete a 12-week course of the medications liraglutide or semaglutide, sold under the brand names Saxenda and Wegovy.
Nearly one-third of patients stopped treatment within four weeks, before reaching the drugs’ targeted dosage. These early dropouts were less likely to achieve the weight loss benefits intended by the medications, the study indicated.
Study Background
Blue Cross Blue Shield Association is a federation of numerous for-profit and nonprofit companies providing health insurance for about 118 million people across all 50 states. The insurer released this non-peer-reviewed data to help decision-makers and the public understand the usage patterns and success factors for these popular weight-loss drugs, explained Razia Hashmi, vice president for clinical affairs at Blue Cross Blue Shield.
A spokeswoman for Novo Nordisk, the company that markets Saxenda and Wegovy, declined to comment on the study, which has not been published in an independent medical journal.
Popularity and Cost of GLP-1 Medications
GLP-1 (glucagon-like peptide-1) receptor agonists, the class of drugs to which Saxenda and Wegovy belong, have become extremely popular. Quarterly sales of anti-obesity drugs exceeded $1.1 billion by mid-2023, according to a Congressional Budget Office report.
Initially developed to treat diabetes, these drugs were later approved for weight loss and heart disease. Drug companies are also exploring other potential uses for GLP-1s, which can cost over $10,000 annually out of pocket.
Given the widespread use and high cost of these drugs, Hashmi emphasized the importance of understanding how patients use these medications and whether they achieve the intended health benefits. It is also crucial to understand why a significant portion of patients discontinue the drugs before reaching the effective dosage.
Factors Influencing Treatment Adherence
The study found that patients prescribed weight-loss drugs by an endocrinologist or obesity specialist were more likely to continue their treatment. Additionally, patients who frequently visited their doctor or prescriber during the first 12 weeks were more likely to stay on the medications. Young adults between 18 and 34 were the most likely to stop the medication before completing the prescribed course.
Saxenda, requiring daily injections, was the only GLP-1 drug approved for weight loss from 2014 to 2021. During that period, fewer than 6,000 individuals started the medication each year. However, when Wegovy, a weekly injectable, gained FDA approval for weight loss in 2021, prescriptions surged, reaching nearly 121,000 in 2023.
Efforts to Manage Costs
Employers and health insurance plans are trying to curb spending on these drugs. Many insurers have imposed requirements such as prior authorization or step therapy, which mandates trying less expensive drugs first. In some cases, employers and insurers are denying coverage altogether.
The study did not address how different Blue Cross Blue Shield insurance plans cover these weight-loss medications. Hashmi stated that Blue Cross Blue Shield will not use this study’s findings for coverage decisions until the study is published and peer-reviewed.
“Our coverage decisions are always based on published, evidence-based studies and literature,” Hashmi said. “This study adds to the knowledge about real-world evidence, but until it’s published and peer-reviewed, it won’t be part of the criteria.”
Employer Perspectives
James Gelfand, president and CEO of the ERISA Industry Committee, which represents companies providing employee benefits, noted that employers will closely watch whether patients adhere to these medications.
“It can take a year or more to get real results from these $1,000-per-month weight loss medications,” Gelfand said. “When patients quit early, as most patients do, that money was wasted. The result is higher health insurance costs for everyone on their employer’s health plan.”
By understanding these trends and the factors influencing patient adherence, stakeholders can better address the challenges associated with the use of weight-loss medications and manage the associated costs.