Weight-loss medications were very much in the news this year, and the pages and website of Managed Healthcare Executive were no exception. Articles on off-label use of the GLP-1s such as Ozempic (semaglutide) and the FDA approval of Zepbound (tirzepatide) garnered the most page views.
They are the trendy way to lose weight, and payers have been noticing an increase in GLP-1 claims. An analysis of the pharmacy and healthcare claims of a small commercial health plan in Texas documents the growth in the off-label usage of the GLP-1s, such as Ozempic, for weight loss.
Insurers are using prior authorization and other managed care strategies to control costs associated with the growing number of prescriptions, on- and off-label, for the weight-loss medications.
Patients with heart failure and obesity who were administered semaglutide experienced better results — they reported fewer symptoms, felt less physically limited, lost more weight, and could walk longer in a 6-minute test.
Tirzepatide, with the brand name Zepbound, is expected to be available by the end of the year in six doses at a list price of $1,059.87, which is about 20% lower than semaglutide.
The Minnesota-based pharmacy benefit manager says a program that resulted in patients switching from two incretin therapy prescriptions to one yielded $7,500 in savings per patient and a total of $3.5 million.
Conversations With Perry and Friends: Paul Fronstin, Ph.D.
May 9th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. In this episode, his guest is Paul Fronstin, Ph.D., director of health benefits research at the Employee Benefit Research Institute.
Listen
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
Listen