Capital Rx
Highlights
- Health plan stakeholders' concerns about the "budget-busting" potential of wider use of GLP-1s for weight loss are justified.
- It's too early for truly informed decisions about how best to cover the GLP-1s for weight loss for members and beneficiaries - there isn't enough data available to model an accurate ROI estimate.
- Solutions that blend responsible utilization management tools like prior authorization and step-edits coupled with programs that drive behavior change with a focus on de-prescribing will likely drive positive clinical and financial outcomes.
The replay of Virta Health's June 15, 2023, webinar is available! Over 1,000 health plan and benefits leaders attended the discussion to learn more about the prevalence of obesity in America and the rise of glucagon-like-peptide-1 (GLP-1) drugs and lifestyle programs for weight loss. Capital Rx's Senior Vice President of Pharmacy, Sara Izadi, PharmD, joined Virta's President, Kevin Kumler, Commercial Health Director, Frank Dumont, MD, FACP, and Chief Medical Officer, Adam Wolfberg, MD, MPH, to provide holistic feedback on the use of GLP-1s for weight loss, rising pressure on health plans to cover this new drug class, and other clinical strategies to address obesity. They also discussed the latest trends in utilization management, what leaders should consider doing in light of surging interest and costs, and much more.
Timestamps
- [3:13] What's behind the surge in GLP-1 utilization and costs
- [10:08] Dr. Dumont explains the clinical care model for obesity and how GLP-1s fit in
- [18:31] Market trends and utilization management strategies for addressing the GLP-1 surge
- [24:03] Panel discussion with Dr. Adam Wolfberg (Chief Medical Officer, Virta Health) and Sara Izadi (SVP, Pharmacy, Capital Rx)
Related Content
For more information about GLP-1s and what Capital Rx sees in the market, check out GLP-1s are No Laughing Matter by Sara Izadi (March 2023), and you can access a PDF of Questions to ask your weight loss or GLP-1 partner here.
The results from Virta's Executive Survey on GLP-1s are available here: How Health Plan Leaders Are Handling the GLP-1 Cost Crisis [Survey Report]
Contact us for more information about Capital Rx's full-service pharmacy benefit management solutions, Medicare and Medicaid claims processing capabilities, or clinical programs that help plan sponsors manage drug utilization and chronic conditions.