Biotech
Wednesday, September 11th, 2024 4:10 pm EDT
Key Points
- GLP-1 Medications and Eligibility: Over 57 million insured U.S. adults under 65 could be eligible for GLP-1 drugs like Wegovy and Ozempic for treating Type 2 diabetes and obesity. However, employer-sponsored health plans may impose additional requirements, such as higher BMI thresholds, potentially limiting eligibility.
- Rising Demand and Costs: Though only 3% of insured adults had prescriptions for GLP-1 drugs in 2022, demand is rising. Employers are weighing the high monthly cost of these medications ($1,000) against their clinical benefits, with some covering GLP-1s only for diabetes management.
- Expansion of GLP-1 Use: Novo Nordisk and Eli Lilly are exploring new uses for their drugs, such as treating fatty liver disease and chronic kidney disease, which could increase the number of eligible patients as approvals for these conditions are anticipated in the next year.
A new analysis by health policy research organization KFF reveals that over 57 million insured U.S. adults under 65 could be eligible for popular weight loss and diabetes medications called GLP-1s, such as Novo Nordisk’s Wegovy and Ozempic. These drugs, approved for treating Type 2 diabetes and obesity, can help patients with weight-related health conditions like cardiovascular disease or high cholesterol. Novo Nordisk’s Wegovy is also the only GLP-1 medication approved to reduce the risk of heart attacks, strokes, and death in obese or overweight adults with cardiovascular disease. However, eligibility may vary based on employer-sponsored health plans, which can impose additional criteria such as higher BMI requirements. For instance, adopting a BMI threshold of 35 or more would reduce eligible adults to 14.6 million.
Despite growing demand, only 3% of insured adults had prescriptions for GLP-1s in 2022, although the number has likely increased since then. KFF found that around 6% of all U.S. adults reported currently taking a GLP-1 drug, with 12% having taken them at some point. The high cost of GLP-1s, averaging $1,000 per month, makes coverage decisions challenging for employers. Some insurance plans cover GLP-1s only for diabetes management, not obesity.
The future of GLP-1 drugs could expand further as companies like Novo Nordisk and Eli Lilly explore new uses, such as treating fatty liver disease and chronic kidney disease. Approvals for these conditions could come in the next year, potentially increasing the number of people eligible for GLP-1 treatments.
Additionally, Apple recently announced new health features for its products, including the Apple Watch Series 10 and AirPods Pro 2. The watch now includes a sleep apnea detection feature using an accelerometer to track breathing disturbances and generate detailed reports for doctors. Apple expects regulatory approval soon for this feature. Meanwhile, AirPods Pro 2 introduced hearing aid capabilities with a clinically validated hearing test, designed to assist people with mild to moderate hearing loss. Both devices underscore Apple’s growing presence in the healthcare space, but it remains to be seen if these innovations will drive consumer purchases.
For the full original article on CNBC, please click here: https://www.cnbc.com/2024/09/10/healthy-returns-57-million-privately-insured-adults-eligible-for-glp-1s.html
