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The expected market growth for GLP-1 drugs also creates a significant business opportunity for weight loss and digital health behavioral change solutions. What should digital health companies do now? Read latest article from Research2Guidance

Key takeaway from this article: "Health plans, clinical teams, patients, and – more broadly – society must deploy a full range of comprehensive population health tools to get the nation back to a healthy weight." "Clinicians and policymakers must resist the seeming quick fix of GLP-1s. Greater attention and resources must be devoted to treating the whole person." "Ultimately, the price paid to people’s long-term health may be more concerning than the price paid out-of-pocket." Yes! There is a huge difference between treating cardiometabolic diseases, (including obesity) and managing and medicating the symptoms. Comprehensive care is necessary. But how do we provide this? Healthcare is fragmented. Even if health plans cover all of the pieces necessary for comprehensive care (which they rarely do), coordinating them into something truly comprehensive is a monumental task. Who is expected to coordinate and oversee this for patients? Clinicians are already collapsing under the burden of treating chronic disease. Asking them to steer this is unrealistic. Furthermore, we don't have the resources or the funds to deploy this type of program at scale. Yet, patients want (and need) it. They are searching for help. Journeys Metabolic is a physician-developed, prescriptive digital therapeutic that delivers an intensive lifestyle intervention targeting the root cause of cardiometabolic diseases. If you are a health plan or a hospital system looking for a way to help patients with their cardiometabolic health, why not provide them with something robust, based on science? Something that extends healthcare into the home, helping the patients and easing the burden on your primary care clinicians? Without direction, people will find solutions on their own. And relying on TikTok influencers' advice is unlikely to create lasting improvements in health. https://lnkd.in/gijeiw3u

Tailoring Treatment: Why Local HTAs Matter for Obesity Coverage. The rising costs of anti-obesity medications emphasize the need for informed coverage decisions. A recent Health Affairs article highlights an expected Medicare Increase Annual Spending By $3.1 Billion To $6.1 Billion with anti obesity medications coverage, such findings raise a need to conduct local HTA reviews assissing the need of coverage and impact. Why local HTA matters: - Tailored coverage: HTA considers regional obesity prevalence to ensure treatments align with specific needs. - Cost-effectiveness: HTA evaluates the financial feasibility of treatments, ensuring they offer the best value. - Prioritizing interventions: HTA identifies the most effective treatments for a given population. Benefits of local HTA: - Equitable access: Ensures treatments reach everyone in need. - Informed decision-making: Provides policymakers and healthcare providers with valuable evidence. https://lnkd.in/gzvXH93A #obesity #publichealth #HTA #healthcare #healthcarepolicy #pharmaceuticals #coveragedecisions #VBHC

New weight-loss medications offer hope in addressing the #obesity crisis, but high costs create barriers to access. Expanding #Medicare coverage for these drugs could provide substantial health and financial benefits, according to a #USCSchaeffer Center white paper. Researchers estimate: - $175 billion in Medicare cost offsets in the first decade; - $700 billion in savings over 30 years; - 53% reduction in obesity prevalence among Medicare recipients after 10 years. These findings are particularly relevant for communities of color, who are disproportionately affected by obesity. https://lnkd.in/g6zHCNub USC Sol Price School of Public Policy   USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences

GLP-1 medications like Ozempic and Wegovy are hot, attracting headlines and leaving payers scratching their heads. But experts warn: these drugs won't magically solve the U.S. obesity crisis. Key takeaways: - Obesity is complex: It's more than just a number on the scale. Experts like Shelley Turk (Blue Cross and Blue Shield of Illinois) emphasize the need for a holistic approach. - Fragmentation is the enemy: Patients often face a confusing maze of specialists, lacking a "quarterback" to coordinate care. Turk blames lack of primary care training and incentives for obesity management. - Data, not drugs, hold the key: Payers and providers need to connect the dots on individual patients' health data to personalize treatment plans. GLP-1s might be part of the answer, but other options like nutrition coaching and surgery should also be considered. - Community matters: Mamata Majmundar (Evry Health) reminds us that social factors like walkable cities and healthy food access play a crucial role in tackling obesity. Payers can't ignore these issues. Learn more: https://hubs.ly/Q02j90TM0

From my latest (free to read!) story for Bloomberg Law: Blockbuster anti-obesity medications are straining the budgets of state health plans and Medicaid programs—a growing problem analysts and researchers say requires more innovative payment models to ensure the drugs are accessible to patients. North Carolina’s State Health Plan voted Jan. 25 to stop covering GLP-1 medications like Novo Nordisk’s #Wegovy and #Ozempic and Eli Lilly and Company’s Zepbound for its roughly 480,000 state employees. The plan’s board of trustees cited the rising prices from drugmakers, which led the health plan to spend more than $100 million on the drugs in 2023. At least 16 state Medicaid programs cover one or more weight-loss medications, and just 10 programs broadly cover the drugs. With list prices for the drugs ranging from just under $1,000 to more than $1,300 per month, more state employee plans and Medicaid programs are likely to follow North Carolina’s lead and decide to not cover them, researchers and policy analysts say. Health plans already pay for the long-term health costs associated with obesity—including treatments for heart disease and hypertension—so states would be better off coming up with ways to ensure access to the drugs for those most at risk for these conditions, analysts say. Researchers and state officials argue this requires payment models like subscription agreements with manufacturers or coverage based on the value of the treatment, which analysts say would balance patient needs with the goal of limiting the financial burden on states. “Increasingly when we see these types of drugs that are safe and effective, and may really benefit from being in the hands of many people,” states “are going to have to try to these types of models,” said Ameet Sarpatwari, an assistant professor of medicine at Harvard Medical School. More here: https://lnkd.in/gqnV-4yB

GLP-1's were a hot topic at the JP Morgan Health Conference last week with a focus on how employers can provide access to these medications as part of an overall obesity care strategy. FORMfit is a proprietary employer offering that ensures all employees with obesity have access to specialized clinical care rather than cutting off access due to budgetary constraints. Employers ready to invest in GLP-1s can offer comprehensive wrap-around clinical care that maximizes results and ROI. Employers looking to control cost can leverage FORMfit to manage GLP-1s while providing a high-impact obesity solution that utilizes lower-cost or no medications. Want to learn more? Reach out to employers@formhealth.co

After 31 years of working as a dietitian in the prevention and management of obesity and type 2 diabetes, I have seen how powerful lifestyle can be to manage these conditions, reduce/omit medication and place conditions into remission (without side effects). However, it is shocking that there is an increasing emphasis on the pharmaceutical management of long-term conditions. This is largely unnecessary and can be detrimental to health and wellbeing. Film Review: Dr. Aseem Malhotra's new documentary "First Do No Pharm" - https://lnkd.in/ebHVeTG6

Are GLP-1 drugs a forever commitment? is the topic de jour from Shelby Livingston at Business Insider. Or can a healthcare company such as Virta Health, Noom or WeightWatchers, really get you off the $1,000 a month medication… with diet and exercise? Well respected obesity medicine physician Michael Albert MD says ‘…It's very unscientific…’ and further that ‘…It's unethical… because you're misrepresenting the science and making promises that aren't supported in the science.’ The evidence states that coming off the drug leads to weight regain and a return of chronic conditions; just imagine someone coming off their beta blocker meds prescribed to avoid angina – their angina symptoms would be highly likely to return. Is this an approach to align with health plans that want to cut costs – at the risk of harming patients physically, as well as emotionally. As Dr. Albert puts it, we want to avoid the ‘…potentially devastating emotional toll of programs that rip medication away from a patient…’ but not with an untested approach. Robert Kushner, MD at Northwestern University in Chicago adds ‘…it all needs to be researched. We can't just go out there and do it.’ There is an unpublished academic paper that has been submitted for peer review on the topic, with data showing a maintenance of weight loss after 12 months off the medication; I suggest we await formal publication prior to make any conclusions. And remember, the NHS in the U.K. approved GLP-1 meds, but only for a maximum period of two years – what will happen to these patients is an important and yet unrecognized concern too. Going back to Virta and others, the approach to quit Wegovy, Ozempic or other GLP-1 meds is too much of a promise of a promise, and right now, without scientific credibility to adopt for sure. https://lnkd.in/eaEK36GS