The newest findings reveal that there is not even a slight offset in reduced healthcare expense from weight loss drugs during the first two years of use.
How should this change your weight loss drug strategy? Answer: not at all. For starters, an industry-financed study shows that there is a 10% reduction in all-cause hospital admissions. That works out to be about twice as high as the 20% reduction in heart attacks and strokes that our Weight Loss Drug Economics Calculator includes, based on the earlier industry study. It still wouldn't come close to paying for these drugs.
No matter...
...The reason you cover these drugs is to give employees access to them, since – at least for some users when used correctly – they can be life-changing. Sure, maybe not during the two initial years tracked in that research, but certainly in the long term.
The problem is that, much to their own frustration, 64% of users drop out within 10 months (and 75% within two years, according to the new research) – after incurring great expense to your plan but before staying in long enough to get a clinical benefit.
Indeed, so many users try the drugs and then drop out that many large groups – including the 10th-largest state program in the country – have stopped covering the drugs altogether. They simply can’t afford to subsidize the “GLP-curious” majority, who will drop out, in order to support the “GLP-serious” minority, those who would decidedly benefit from these drugs. So everyone gets...
The biggest reason for dropping out among insured users? Expectations are being raised unrealistically by paid celebrities, influencers and very aggressive advertising. So users expect easy, riskless weight loss. This misconception, as you'll see below, is exactly what our GLP health literacy education addresses, before employees/members even start on the drugs...
The Solution, Part I: Employee Education
As I used to say when I taught economics: “Economists learn that the answer is never all or none.” This is a perfect example. Maybe you can’t afford to cover all comers, and maybe there is an issue with losing rebates if you try to modulate demand using your own prior authorization. Yet the alternative needn't be to cover no comers.
Instead, you can provide your employees with our weight loss drug education curriculum. Education doesn't count as prior authorization, so PBM contracts would not prohibit it. Education is a critical path to optimizing your drugspend because weight loss drugs are by far and away the most health literacy-intensive drugs ever.
Our health literacy curriculum for weight loss drug users accomplishes the following:
It will help employees decide whether they want to try the drugs. Many are not aware of three things: the required lifestyle changes, the side effects and the long-term risks.
Speaking of which, we’ll look at a couple of sample questions below that specifically address the importance of education for all three.
Finally, if you are budget-constrained, our initial quiz can be dialed-up to discourage likely dropouts from starting at all, with questions like this one and this one. Rather than closing the weight loss drug opportunity for everyone, adding questions like these to the initial quiz allows you to finetune the number of users to optimally deploy a limited budget to support and educate the users who are most likely to commit long enough to realize a clinical benefit.
Let’s review a couple of sample questions that hit the sweet spot for all three things – not just raising awareness of side effects and risks, but also educating specifically on how to avoid them with lifestyle changes. This is truly the Holy Grail of member education. Consider this one:
The first choice is correct. (The second is a bariatric surgery risk. Quite the opposite is true for GLP-1s. The third is also the opposite – blood pressure should decline for GLP-1 users. And the last choice is a well-known "catch," not an overlooked one.)
Do your employees know that their sense of thirst will be suppressed? Did their doctor – who simply wants to write the script, give basic cautions, and move on – take the time during this brief, tightly scheduled, visit to go over all the education that patients need?
Ask anyone – anyone – who has been prescribed these drugs if they were told that it is very important to drink water when they aren’t thirsty.
To elaborate on this answer, here is the explanation that accompanies it:
Note that we don’t just point out the problem. We show employees an easy way to solve it. to substantially reduce the very serious risk of kidney injury. WIth links if they want more info, as about half of them do.
Likewise…
It’s fiber. Once again, ask anyone if their doctor brought this to their attention. Even people who aren't "eating less" risk a deficiency, as fiber is sorely lacking in the American diet.
We don’t just bring this to employees’ attention. While not as easy as drinking water, adjusting your diet to avoid the possibly irreversible risk of damage to the gut is the subject of subsequent questions in the first quiz, as well as subsequent quizzes.
The Solution Part 2: Compelling Economics
These drugs cost hundreds of dollars/user every month, and the average dropout stays on these drugs for 4-5 months. Quizzify's solution costs a small fraction of one month's weight-loss drugspend.
The ROI should be intuitive, but you might ask: "But I'm not just paying for people who learn about the required lifestyle changes and possible side effects who decide not to continue. I'm also paying for those who continue. Doesn't that dilute my ROI?"
Well, that's easy. You don't pay for the "GLP-serious" users who continue. Quite the oppositye, we provide the entire monthtly ongoing educational curriculum to those users gratis. That locks in your immediate ROI, rather than diluting it. And helps thoe GLP-serious users be successful.
The Solution, Part 3: Easy Implementation
While some so-called “next-gen” PBMs (names on request from this expanding list) are eager to work with you on this, you can do this completely on your own.
Simply adjust the “points” in your wellness incentive program. With no involvement at all by the PBM, your rebates would remain intact. What you do through that program is not legally utilization management, and is not prohibited by any PBM contract.
Consider this classic wellness incentives example. (Apologies for the blurry screenshot.)
Not one of those items saves a nickel right away, and not one of them educates your employees on anything they don't already know. (As I often say when I present in conference sessions on wellness: "Raise your hand if you don't already know you need to lose weight and stop smoking.") Most of them can be gamed or multitasked. So why not allocate some money/'points" to playing our weight loss drug quizzes? Nothing to lose.
We educate on topics and factoids that employees actually might not know, as in the example questions above. And the things we educate them on don't have some theoretical value down the road, but rather have immediate value to avoid near-term harms.
If you are budget-constrained, you can offer our longer quiz that includes more questions to persuade the "GLP-curious" not to try these drugs in the first place, only to drop out six expensive months later. The number and selection of questions from our universe is totally up to you, driven by your budget and strategy.
Finally, it is certainly not the case that people with no interest in these drugs will take the quiz to earn the dollars or points, costing you money. They may do that, but those are exactly the employees who would otherwise figure out some other way of collecting the credit.
You have a major problem. We have a unique solution. No downside, no risk of losing rebates, no denying your employees, and easy implementation. Gamble a half-hour that we might save you millions while increasing the likelihood of success for those who go on these drugs.
