Holistic Care for Diabetes and Obesity | Personalized Approach - Prime Therapeutics
Support your members with diabetes and obesity
Learn more about diabetes
38M
Diabetes affects 38M+ children and adults in the United States — that’s 1 in 10 Americans.1
2.6x
People with diabetes have health care costs approximately 2.6x higher than those without.2
$412B
Total annual direct and indirect costs of diabetes in the United States is estimated at $412 billion.2
Learn more about obesity
41%
According to the CDC, more than 41% of U.S. adults are obese.3
6x
Those with obesity are about six times more likely to develop type 2 diabetes than those at a healthy weight.2
What is a GLP-1?
Recently, a class of drugs called glucagon-like peptide-1s (GLP-1s) have come into the spotlight as an effective therapy to fight obesity. GLP-1s have historically been used to manage type 2 diabetes. Their effectiveness in preventing cardiovascular events among those with type 2 diabetes has resulted in GLP-1s being one of the American Diabetes Association’s (ADA) recommended first-line therapies. The FDA has approved select GLP-1 therapies specifically for weight loss, and there has also been a substantial increase in people using type 2 diabetes GLP-1 therapies for weight loss despite these therapies not being approved for weight loss by the FDA. The seismic increase in prescription sparked by media attention created shortages for many key GLP-1 drugs.4
85%
85% of people who started GLP-1s for weight loss without diabetes were no longer taking the drug after two years, a 14% decrease in persistence from 2023. At two years, 26% of people switched GLP-1 drugs during therapy — an 11% increase from 2023.4
3
Diabetes is the third most expensive drug category, based on Prime’s commercial claims data. And 1 in 15 members had a diabetes drug claim in the most recent quarter.4
Top 10
When a customer covers GLP-1 weight loss medications, their utilization and costs place them in top 10 drug spend category.
A comprehensive approach to savings
Preventive programs
Empower your members to take control of their health journeys through improved adherence, health education and proactive communication.
Data integration & intervention
Tap into clinical reporting and medical, pharmacy and member data to improve adherence, drive lower costs and promote affordability.
Personalized care
Provide customized guidance from our team of professionals, who simplify the experience for your members with personalized support.
Clinical rigor
Help your members get the right treatments with comprehensive policies, proactive pipeline monitoring and rigorous utilization management (UM).
Choose what works best for you and your members
Footnotes
*All brand names are property of their respective owners.
**The programs listed are not available to all clients. Please check with your representative if you are interested in learning more.
1 National Diabetes Statistics Report. (2024, May 15). Diabetes. https://www.cdc.gov/diabetes/php/data-research/?CDC_AAref_Val=https://www.cdc.gov/diabetes/data/statistics-report/index.html
2 $412.9 billion in health care dollars |ADA. (n.d.). https://diabetes.org/newsroom/press-releases/new-american-diabetes-association-report-finds-annual-costs-diabetes-be
3 Marshall, L. Z., Espinosa, R., Starner, C. I., & Gleason, P. P. (2023). Real-world outcomes and direct care cost before and after elexacaftor/tezacaftor/ivacaftor initiation in commercially insured members with cystic fibrosis. Journal of Managed Care & Specialty Pharmacy, 29(6), 599–606. https://doi.org/10.18553/jmcp.2023.29.6.599
4 Internal analysis, 2024