Analysis finds most patients stop using Wegovy, Ozempic for weight loss within two years, ET HealthWorld

Analysis finds most patients stop using Wegovy, Ozempic for weight loss within two years, ET HealthWorld


by Chad Terhune

LONDON: Only one in four US patients who took Novo Nordisk's Wegovy or Ozempic for weight loss was still taking the popular drugs two years later, according to an analysis of US pharmacy claims provided to Reuters. The analysis also found that use has been steadily declining over time.

The analysis doesn't provide details about why patients quit the drug. But it does offer a longer look at the real-world experiences of patients taking the drug, whereas previous research has studied use for a year or less.

There is evidence that many people stop using weight-loss therapy shortly after starting it, which has sparked debate over the cost to patients, employers, and government health plans.

Wegovy and similar medications, which belong to a class of drugs called GLP-1 receptor agonists, can cost more than $1,000 per month, and may require long-term use to see meaningful benefits.

Their prices in the US have recently been strongly objected to by President Joe Biden and other public officials, who have said that such drugs could cost the country $411 billion a year if only half of obese adults use them. That's more than the $5 billion Americans spend on all prescription drugs in 2022.

“GLP-1 is not cost-effective for everybody,” said Dr. Rekha Kumar, an obesity specialist at New York Presbyterian-Weill Cornell Medical Center and chief medical officer of the online weight-loss program Found. “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, reviewed pharmacy and medical claims data for 3,364 people who have commercial health plans that cover GLP-1 drugs. They all had received new prescriptions between January and December 2021, and were diagnosed with obesity or a body mass index of 30 or higher.

The PBMs excluded patients using the drugs for type 2 diabetes, for which these drugs were originally developed. The average age of patients included in the analysis was 46.5, and 81 percent were women.

Last year, PRIME published data that found 32 percent of patients were still taking a GLP-1 drug for weight loss 12 months after their initial prescription. The new data show that overall, for all the drugs included in the study, only about 15 percent were still taking their medication after two years.

For Wegovy, 24.1 percent of patients continued therapy for two years without a gap of 60 days or more, compared with 36 percent of patients who took the drug for one year. With Ozempic, which has the same active ingredient as Wegovy — semaglutide — 22.2 percent of patients kept filling their prescriptions for two years, compared with 47.1 percent of patients who used it for one year.

Older GLP-1 drugs fared even worse. After two years, only 7.4 percent of patients were taking Novo's Saxenda, a less potent weight loss drug that some health plans require patients to take before newer GLPs such as Wegovy or Eli Lilly's Zepbound.

The analysis found that 45 percent of patients were taking Ozempic or Wegovy. The others were taking Saxenda or Victoza, which are both liraglutide, Rybelsus, which is an oral version of semaglutide, or Lilly's Trulicity (dulaglutide).

The analysis also found that 26 percent of patients switched GLP-1 medications during treatment, likely reflecting a decrease or change in insurance coverage, according to Dr. Patrick Gleason, assistant vice president of health outcomes at Prime/MRx and a co-author of the analysis.

Both Novo and Lilly have been unable to meet the unprecedented demand for new drugs.

'Nobody really knows'

Novo Nordisk cited several limitations of the analysis in a statement. 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 could affect patients’ coverage and persistence with the therapy, the Danish drugmaker said.

The company said it “believes these data are not sufficient to draw conclusions about overall patient compliance and persistence to various GLP-1 medications, including our treatments.”

In clinical trials, new GLP-1s helped people lose more than 15 percent of their body weight by reducing appetite and promoting a feeling of fullness. They are being tested for a number of other health benefits that could improve insurance coverage.

Wegovy received U.S. approval in March to reduce the risk of stroke and heart attack in overweight and obese adults.

The analysis did not track long-term use of Lilly's Monjaro and Zepbound, which were 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's likely a mix of side effects like nausea and vomiting, out-of-pocket expenses not covered by insurance, and supply shortages.

Doctors said some patients may decide to stop the medication after successfully losing weight. Other studies have shown that most patients who stop their GLP-1 medications typically regain most of the weight.

“Nobody really knows how long you should take these medications,” said Dr. Walid Gellad, a professor of medicine at the University of Pittsburgh who studies medication adherence.

Kumar said some clinics and telehealth services are not properly screening patients or providing adequate training on nutrition and exercise along with medication, resulting in poor outcomes and patients discontinuing their medications.

Prime/MRX owns 19 American Blue Cross and Blue Shield health insurance plans and manages pharmacy benefits for approximately 38 million people.

Dr. David Lassen, PBM's chief clinical officer, said the continued deterioration in disease response even after two years of treatment is concerning.

“It's not about plateauing, but rather about getting a little worse,” he said. “It's really about sustainability of weight loss to get long-term results.”

(Reporting by Chad Terhune; Editing by Michele Gershberg and Bill Berkrot)

  • Published on July 10, 2024 at 04:36 PM IST

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