GLP-1 Drug Coverage: Challenges and Emerging Strategies for …

The rising demand for GLP-1 drugs is driving up costs for payers. Learn about innovative strategies like price caps and utilization limits to manage access and pricing for these high-demand therapies, including Wegovy and Zepbound.

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Escalating Specialty Drug And GLP-1 Costs—and The Strategies To …

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Price: The annual per-member price tag of GLP-1 marketleader Wegovy® exceeds $16,000. Continued demand: The GLP-1 market is forecasted to grow from $22 billion in 2024 to $105 …

quantum-health.com

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The GLP-1 Dilemma Persists Into 2025 - Becker's Hospital Review

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Dec 26, 2024 · The financial strain caused by GLP-1 drugs has been evident in insurers' financial reports throughout the year. Pittsburgh-based UPMC reported an operating loss of $371 …

beckershospitalreview.com

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GLP-1s: What You Need To Know Now To Prepare For 2025

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Dec 4, 2024 · According to KFF, the annual cost of these drugs in the U.S., upwards of $11,000 at recent list prices, has raised concerns about the fiscal impact of broad coverage of GLP-1 …

truerx.com

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The Skinny On Emerging GLP-1 Exposures For The Healthcare …

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Recent polling finds that about one in eight adults (12%) report having taken a GLP-1 agonist.11 The huge demand for these drugs is leading to medication shortages, inconsistent insurance …

crcgroup.com

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Five Key Trends Impacting The Future Of GLP-1s

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Oct 8, 2024 · The high cost of GLP-1 drugs remains a significant hurdle for many patients. Some can cost as much as $16,000 annually, or $1,300 per month. Increased competition. New GLP …

meritain.com

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The Promise And Challenge Of GLP-1 Medications: Ensuring ROI In …

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Nov 26, 2024 · Emerging real-world data reveals a troubling trend: many patients don’t stay on GLP-1 medications for the long term. Studies report that up to 50% of patients discontinue …

medcitynews.com

FAQs about GLP-1 Drug Coverage: Challenges and Emerging Strategies for … Coupon?

How will GLP-1 drugs affect employer health plans?

With several more GLP-1 drugs expected to hit the market by 2026, costs for employer health plans are likely to continue to rise. Employers are considering various coverage and management strategies for GLP-1 drugs, such as prior authorization, limiting coverage to certain individuals and setting higher cost-sharing requirements. ...

Why are GLP-1 drugs so expensive?

The high cost of GLP-1 (glucagon-like peptide 1) drugs is straining employer healthcare budgets as they are increasingly used for treating obesity. With several more GLP-1 drugs expected to hit the market by 2026, costs for employer health plans are likely to continue to rise. ...

Should employers consider additional management strategies for GLP-1 drugs?

Employers can consider additional management strategies for GLP-1 drugs. However, this could result in the loss of rebates to the plan and an increase in administrative costs. Regardless of chosen strategies, employers carefully monitor impact on utilization, PBM/vendor, and medical costs. ...

Are GLP-1 drugs safe?

Clinicians are familiar with the safety and side-effects of GLP-1 drugs as they have been used for treating diabetes since GLP-1 drugs were first approved in 2005. Yet when a drug is used by more people for a different purpose than originally intended, the FDA tracks adverse events to identify safety concerns. ...

How many GLP-1 drugs are used in the RX collaborative?

The 2022 WTW Rx Collaborative Annual Report found that, across all Collaborative employers, two of the top four drugs by spending were GLP-1’s used for diabetes. The graphic below shows that four GLP-1 drugs account for 9% of the overall prescription cost for the Rx Collaborative after rebates and discounts. ...

Should employers cover GLP-1 agonists?

The decision to cover weight-loss drugs, including GLP-1 agonists, is an individual decision to be made by each employer. Though there are several potential benefits, and they are effective, they come at a significant cost. ...