March 3 RxAdvocate March, 2024 — Newsletter
March Stories:
- Wegovy Approved to Decrease Cardiovascular Risk
- Oprah’s Recent Take on Weight Loss Medications & What You Should Know
- FDA Approves New Gene Therapy
- Employee Spotlight
Wegovy Approved to Decrease Cardiovascular Risk
Recently, Oprah Winfrey hosted a primetime special discussing the utilization of GLP-1 weight loss medications: Wegovy (semaglutide), Saxenda (liraglutide), and Zepbound (tirzepatide). The overall tone of the special was in support and promotion of these medications with little discussion of adverse effects and costs.
Oprah highlighted her success utilizing one of these medications and spoke with various guests who had similar experiences with their own weight loss journeys. Executives from the drug manufacturers of these products, Eli Lilly and Novo Nordisk, were also in attendance as well as paid medical consultants. The weight loss drug class has historically been excluded from coverage by many payers who consider it a “lifestyle” or cosmetic treatment. Clinically, the focus of obesity management has been to emphasize behavioral interventions vs pharmacologic therapies. However, with the introduction of these GLP-1 weight loss medications to market, coupled with strong advertising and celebrity endorsement, weight loss drug coverage has been brought to the forefront of many conversations.
Due to the extraordinary high cost of these treatments, the financial impact of providing coverage of weight loss medications is significant and the resultant increase in premiums makes the decision for employers to cover quite difficult. These medications are currently available brand only and cost $1,100 – $1,400 per 30-day supply. Additionally, there is no data available at this time showing the utilization of these therapies results in medical spend cost avoidance. However, there is data showing they do exceed cost-effectiveness thresholds. Of note, in 2023 only ~25% of employers covered weight loss medications. Please review our info brief here for more information regarding employer weight loss medication coverage:
FDA Approves Gene Therapy for Children with Metachromatic Leukodystrophy
Lenmeldy was recently approved by the FDA for the use in children with pre-symptomatic late infantile, pre-symptomatic early juvenile or early-symptomatic early juvenile metachromatic leukodystrophy (MLD). This marks the first treatment option for MLD, which is an inherited disorder that typically causes death in children before their 7th birthday due to toxin buildup in the nervous system controlling movement and thought operations.
MLD is considered a rare disease and approximately 40 children born in the US each year receive this diagnosis. Treatment with Lenmeldy is currently marketed as a cure for patients that receive the infusion but follow up studies will be needed to determine duration of benefit. It is the most expensive medication currently available worldwide with a price tag of $4.25 million. The medication that previously held the title of most costly drug therapy is Hemgenix, priced at $3.5 million, used for the treatment of hemophilia B. The approval for Lenmeldy marks the 12th gene therapy product to enter the US market since the first was approved in 2017.
Employee Spotlight
Please welcome RxConnection’s newest Strategic Account Executive, Aaron Parks! Aaron will manage our clients by serving as the PBM liaison for daily service activities. Aaron brings over 6 years of extensive experience in benefits management. Aaron is based out of Atlanta, GA. We are excited to have him on board!
Please welcome Brittany Maira to the RxConnection team! Brittany will be the Account Manager, providing internal support to the Account Team. Brittany brings over 5 years of experience working in the health care industry. Brittany is based out of Wake Forest, NC. We are happy to have her on this team!
Contact us
Orlando.Neal@rxconnectionllc.com