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Taking a closer look at Prime’s GLP-1 Year-2 cost-of-care findings

David Lassen, vice president of pharmacy clinical services, and Marci Chodroff, vice president and medical director at Prime Therapeutics, share more about the latest GLP-1 insights from ongoing research

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Last week, Prime Therapeutics (Prime) released the latest data from its ongoing real-world research on glucagon-like peptide-1 (GLP-1) agonist drugs, which showed individuals who newly started the drugs for weight loss experienced an average of $4,206 higher cost of care in their second year compared to like members not taking a GLP-1 drug for obesity. The study also shows that, across the obesity-related outcomes included in the study, researchers observed no reduction in medical events over the first two years of therapy. 

These findings are part of Prime’s ongoing GLP-1 research, including its most recent study, which shows 85% of individuals taking GLP-1 drugs for weight loss no longer took the drug after two years.

Prime has cultivated industry-leading insights on GLP-1 drugs, beginning with the release of its Year-1 data in July 2023, which showed 71% of individuals were no longer taking these drugs for weight loss at one year. The research also revealed a substantial increase in health care costs in the first year among those who also started the drugs. Prime released additional adherence findings earlier this year, which found a further 14% point decrease in persistence after two years. This data was illustrated in one of 10 research posters that Prime presented at Academy of Managed Care Pharmacy (AMCP) Nexus 2024 in Las Vegas, Nevada earlier this month. 

To take a closer look at the latest cost-of-care data, I (Alex Cook, part of Prime’s newsroom team) connected with Marci Chodroff, M.D., vice president, medical director, and David Lassen, PharmD, vice president, pharmacy clinical services at Prime.


Marci Chodroff (left) and David Lassen (right)


Alex Cook: In this study, we saw that after two years, those taking a GLP-1 drug for obesity and without diabetes, experienced an average of $4,206 higher cost of care in their second year compared to like members not taking a GLP-1 drug for obesity. Generally, what do we see in cost-of-care trends for drugs at the Year-2 mark?
David Lassen (DL): The timeline for improved cost-of-care trends is different for every drug and condition that’s being treated. In general, effective drug treatment (e.g. statins) can prevent major adverse cardiovascular events (e.g., heart attack, stroke) by as early as two to three years. The SELECT trial showed that the GLP-1 semaglutide prevented secondary major adverse cardiovascular events within the study period of 3.3 years. 

Total cost of care is measured by both the pharmacy and medical costs, and the goal is to see that the investment into higher drug costs is outweighed by the eventual decrease in medical costs due to improved outcomes. When this happens, we refer to the drug as having a positive return on investment (ROI)/impact on total cost of care.  

What makes this study so surprising?
Marci Chodroff (MC): We were not expecting to see a higher cost of care (despite the added cost of the GLP-1s) and no reduction in medical events for the patients taking GLP-1s. We expected that patients taking the GLP-1s for obesity may have a lower cost of care and improved medical outcomes as we presumed that the weight loss could have led to a decrease in the frequency of office/hospital visits and/or the use of drugs for treatment of conditions such as hypertension, high cholesterol and osteoarthritis. We understand that many complex factors may have played a role in the study results.

Our prior studies show that adherence for GLP-1 drugs in the real-world is low. What’s the connection between adherence/persistence and cost of care?
DL: Adherence is a measure designed to quantify how well a patient has followed their drug treatment regimen without a lapse in treatment. Persistence measures the time a medication is used continuously from the start of therapy initiation. Both adherence and persistence are important indicators of whether a patient will receive the intended benefits from the intended drug treatment. If the benefits of treatment are not achieved, the increased cost of drug therapy will not produce improved outcomes and associated lower medical costs.  

One of the standout data points from this latest study is the occurrence of pancreatitis, which can be a serious condition. How should clients and members look at this data?
MC:  The data related to the occurrence of pancreatitis is an expected rare event, given that the GLP-1 package inserts include acute pancreatitis in their “Warnings and Precautions” section based on reports of acute pancreatitis as a rare serious adverse event in clinical trials. Although the occurrence of acute pancreatitis in patients taking GLP-1s is infrequent, clients and members should be aware of this serious complication as it relates to health outcomes and cost.

We intend to follow this data into the future. What new angles might we examine as we continue to study the GLP-1 space?
DL: As we look to the future, we intend to measure new populations that include a mix of GLP-1s that have come to market since the initial study time period. Studying these new populations will also enable us to look at the impact of different management strategies deployed since the initial study was started.  Examples include the impact of behavioral/lifestyle modification on study outcomes.  


Learn more about our latest GLP-1 insights.

About Prime Therapeutics

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Prime Therapeutics LLC (Prime) is a diversified pharmacy solutions organization. We offer innovative pharmacy benefit management, specialty and medical drug management, and state government solutions to millions of people across the country. At Prime, we’re reimagining pharmacy solutions to provide the care we’d want for our loved ones. We challenge the way it’s always been done to develop intelligently designed solutions that deliver savings, simplicity and support to help people achieve better health. For more information, visit us at PrimeTherapeutics.com or follow us on LinkedIn

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