The pharmaceutical landscape is no stranger to innovation and transformation, but few breakthroughs have made waves like GLP-1s. Initially developed to manage Type 2 diabetes, GLP-1s have exploded in popularity, leading to unprecedented demand and market expansion. GLP-1 drugs have grown into a $48 billion market, with projections exceeding $471 billion in eight years.
In the latest episode of the Pharmland podcast, RxBenefits’ Tom Davies and Bradley Nelson unpack the rising impact of GLP-1s on healthcare, patients, and pharma, and consider what plan sponsors should anticipate as this therapeutic revolution continues to grow with expanded indications.
Rapid Market Expansion
The story of GLP-1 drugs, like Wegovy, Ozempic, and Mounjaro, has shifted dramatically from diabetes control to addressing multiple health conditions. Through continued research and label expansions, they are now indicated or being studied to treat:
- Weight Loss: With an estimated 100 million adult Americans (nearly 42%) currently living with obesity, GLP-1s will continue to be heavily prescribed for weight management.
- Cardiovascular Risk: Ozempic has shown efficacy in reducing secondary cardiovascular events, making it a valuable treatment for individuals with coexisting diabetes and cardiovascular disease (CVD).
- Obstructive Sleep Apnea: Zepbound has entered the market with its new approval for addressing sleep apnea tied to obesity.
- Ozempic has received approval to reduce the risk of worsening kidney disease and kidney failure (end-stage kidney disease) in adults with Type 2 diabetes and chronic kidney disease.
Clinical trials are also underway for non-alcoholic steatohepatitis (NASH), one of the fastest-growing conditions due to its association with obesity and metabolic syndrome.
And there’s the potential for GLP-1s as treatment for other emerging indications with studies currently exploring applications for Alzheimer’s disease, osteoarthritis, substance abuse, and even inflammatory diseases like psoriasis and inflammatory bowel diseases.
Surging Demand Fueled by Awareness
Consumer awareness around GLP-1s has skyrocketed due to discussions in mainstream media, social channels, and celebrity endorsements. A KFF survey revealed that 12% of the U.S. population has either used or tried GLP-1s – an unprecedented level of interaction for a relatively new drug class.
From celebrities publicly acknowledging using Wegovy to the influence of TikTok trends, consumer fascination with GLP-1s has driven demand beyond initial therapeutic areas. Even pre-diabetic patients are being considered for treatment, potentially expanding the candidate pool significantly.
Challenges for Employers
While the therapeutic promise of GLP-1s is undeniable, the emergence of new labels and indications raises these important considerations for plan sponsors.
- High Costs: GLP-1s don’t come cheap. With annual costs between $10,000 and $15,000 per patient, the potential expense for insurers and self-funded employers is massive.
- Population Growth of Users: In February 2024 alone, more than 700,000 new GLP-1 prescriptions were issued in the U.S. Given the prevalence of diabetes, obesity, and related conditions, demand for these medications will likely continue to rise sharply.
- Managing Eligible Populations: Expanded indications mean expanded eligibility. For plan sponsors, identifying and managing these growing patient populations is critical. Plan sponsors will need help to forecast costs and refine strategies.
Strategic Opportunities
For employers, the rise of GLP-1s presents an intriguing blend of challenge and opportunity. While they may drive innovation in care delivery, questions remain about their long-term potential. Could these medications become the gold standard in preventive care? Perhaps – but it’s worth considering whether that would be the most sustainable path forward. Are there other, more cost-effective solutions already available or on the horizon? Should those treatments be first-line therapies over the much higher cost alternatives?
Empowering plan sponsors with robust data and encouraging innovation will be essential to navigating this evolving landscape. Pharmacy benefits plans must remain agile to accommodate the rapidly shifting dynamics surrounding these medications.
The future of GLP-1s holds considerable promise, but it is not without its complexities. For those looking to stay on top of this evolving space, now is the time to dig deeper, examine the data, and design plans that can adapt to changing landscapes effectively.
For more about GLP-1s, check out these other Pharmland episodes or read our recent article.
