Oxy Oxy, Wherefore Art Thou Oxy?
Jul 16, 2021 12:46:43 GMT
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Post by dnr08 on Jul 16, 2021 12:46:43 GMT
New Obesity Drug Must Convince Insurers That It’s Worth the Cost
2021-07-16 10:00:12.389 GMT
By Emma Court
(Bloomberg Businessweek) -- When a new obesity medication
from the Danish drugmaker Novo Nordisk A/S began selling in the
U.S. in June, it became the most effective weight loss drug on
the market. Wegovy helps patients lose an average of about 15%
of their body weight, almost double the rates demonstrated by
other prescription treatments, according to study results. That
translates to a loss of about 20 to 70 pounds for eligible
patients. Only costly and invasive bariatric surgery has shown
the ability to eliminate more pounds.
Wegovy works by activating parts of the brain that regulate
appetite. Novo, a major manufacturer of diabetes medications, is
pinning its hopes on new weight loss meds to diversify its
business, and Wegovy, which the Food and Drug Administration
approved on June 4, is its most promising offering yet. With
more than 100 million people categorized as obese, the U.S. is a
potentially huge market for Wegovy, which costs $1,350 for four
weekly injections and is being pitched as a long-term therapy.
The drug’s success will depend on overcoming insurers’
resistance to weight loss treatments. “Obesity drugs tend to
have difficulty getting insurance coverage, because we don’t see
obesity to be a disease,” says Caroline Apovian, the co-director
of the Center for Weight Management & Wellness at Brigham &
Women’s Hospital in Boston who serves on Novo’s scientific
advisory board.
Insurance companies, pharmacy benefit managers, and
employers determine whether health plans cover weight loss
drugs, and which ones. Today only about half the clients of
Cigna Corp.’s Express Scripts unit and Prime Therapeutics LLC,
two major pharmacy benefit managers, reimburse for weight loss
drugs. Express Scripts recently added Wegovy to its largest
formulary, covering about 24 million people. Insurers Anthem
Inc. and CVS Health Corp.’s Aetna don’t typically cover weight
loss drugs, but both have indicated Wegovy will likely get some
coverage. Others have yet to decide.
Although “it’s not for everyone,” Wegovy has a role to play
in treating obesity, says Amy Bricker, president of Express
Scripts. She says she’s optimistic that treating obesity will
lower costs for Express Scripts’ health plans.
Still, doctors and patients tend to be skeptical of new
weight loss drugs, especially after earlier treatments had
serious safety issues. Nausea and diarrhea were some of the most
common Wegovy side effects found in studies. The drug will also
come with a warning about potential thyroid cancer risks. Wegovy
is one of some 10 FDA-approved weight loss therapies, a list
that includes inexpensive generics and Saxenda, a Novo drug
introduced in the U.S. in 2015. That medication is expected to
have around $1.1 billion in global sales next year, after which
its patents expire and revenue is expected to fall.
Novo is working to identify patients who best respond to
Wegovy, building on results from clinical trials showing that
about a quarter to half of participants shed 15% or more of
their body weight. Another hurdle will be persuading people to
keep taking the drug. Patients in the U.S. typically stay on
Saxenda for only about six months. That may be because patients
discontinue use after experiencing side effects, after their
weight loss slows, or after facing insurance bottlenecks. For
Wegovy, coverage is “going to build over time,” says Doug Langa,
president of Novo’s U.S. business. “We know we’re going to need
that to really unlock the potential.”
2021-07-16 10:00:12.389 GMT
By Emma Court
(Bloomberg Businessweek) -- When a new obesity medication
from the Danish drugmaker Novo Nordisk A/S began selling in the
U.S. in June, it became the most effective weight loss drug on
the market. Wegovy helps patients lose an average of about 15%
of their body weight, almost double the rates demonstrated by
other prescription treatments, according to study results. That
translates to a loss of about 20 to 70 pounds for eligible
patients. Only costly and invasive bariatric surgery has shown
the ability to eliminate more pounds.
Wegovy works by activating parts of the brain that regulate
appetite. Novo, a major manufacturer of diabetes medications, is
pinning its hopes on new weight loss meds to diversify its
business, and Wegovy, which the Food and Drug Administration
approved on June 4, is its most promising offering yet. With
more than 100 million people categorized as obese, the U.S. is a
potentially huge market for Wegovy, which costs $1,350 for four
weekly injections and is being pitched as a long-term therapy.
The drug’s success will depend on overcoming insurers’
resistance to weight loss treatments. “Obesity drugs tend to
have difficulty getting insurance coverage, because we don’t see
obesity to be a disease,” says Caroline Apovian, the co-director
of the Center for Weight Management & Wellness at Brigham &
Women’s Hospital in Boston who serves on Novo’s scientific
advisory board.
Insurance companies, pharmacy benefit managers, and
employers determine whether health plans cover weight loss
drugs, and which ones. Today only about half the clients of
Cigna Corp.’s Express Scripts unit and Prime Therapeutics LLC,
two major pharmacy benefit managers, reimburse for weight loss
drugs. Express Scripts recently added Wegovy to its largest
formulary, covering about 24 million people. Insurers Anthem
Inc. and CVS Health Corp.’s Aetna don’t typically cover weight
loss drugs, but both have indicated Wegovy will likely get some
coverage. Others have yet to decide.
Although “it’s not for everyone,” Wegovy has a role to play
in treating obesity, says Amy Bricker, president of Express
Scripts. She says she’s optimistic that treating obesity will
lower costs for Express Scripts’ health plans.
Still, doctors and patients tend to be skeptical of new
weight loss drugs, especially after earlier treatments had
serious safety issues. Nausea and diarrhea were some of the most
common Wegovy side effects found in studies. The drug will also
come with a warning about potential thyroid cancer risks. Wegovy
is one of some 10 FDA-approved weight loss therapies, a list
that includes inexpensive generics and Saxenda, a Novo drug
introduced in the U.S. in 2015. That medication is expected to
have around $1.1 billion in global sales next year, after which
its patents expire and revenue is expected to fall.
Novo is working to identify patients who best respond to
Wegovy, building on results from clinical trials showing that
about a quarter to half of participants shed 15% or more of
their body weight. Another hurdle will be persuading people to
keep taking the drug. Patients in the U.S. typically stay on
Saxenda for only about six months. That may be because patients
discontinue use after experiencing side effects, after their
weight loss slows, or after facing insurance bottlenecks. For
Wegovy, coverage is “going to build over time,” says Doug Langa,
president of Novo’s U.S. business. “We know we’re going to need
that to really unlock the potential.”
