Most patients stop using Wegovy and Ozempic for weight loss within two years, analysis finds

Most patients stop using Wegovy and Ozempic for weight loss within two years, analysis finds
Most patients stop using Wegovy and Ozempic for weight loss within two years, analysis finds

Only one in four U.S. patients prescribed Novo Nordisk’s Wegovy or Ozempic for weight loss were still taking the popular drugs two years later, according to an analysis of U.S. pharmacy claims provided to Reuters, which also showed a steady decline in use over time.

The analysis does not include details about why patients stopped. But it offers a longer view of patients’ real-world experience taking the drugs than previous research that studied use over a year or less.

Evidence that many people may stop using weight-loss therapies soon after starting them is influencing the debate over their cost to patients, employers and public health plans.

Wegovy and similar drugs, which belong to a class of medications known as GLP-1 receptor agonists, can cost more than $1,000 per month and may require prolonged use to produce significant benefits.

Their price in the United States has recently drawn criticism from President Joe Biden and other public officials, who have said that the drugs could cost the country $411 billion a year if only half of obese adults used them. That’s $5 billion more than Americans spent on all prescription drugs in 2022.

“GLP-1s for all are not cost-effective,” said Dr. Rekha Kumar, an obesity specialist at New York Presbyterian-Weill Cornell Medical Center and chief medical officer of Found, an online weight-loss program. “People want to provide obesity care to their employees, but they want to do it in a way that doesn’t put them out of business.

Prime Therapeutics and Magellan Rx Management, a pharmacy benefit manager, reviewed medical and pharmacy claims data from 3,364 people with commercial health plans that covered GLP-1 drugs. All of these people had new prescriptions between January and December 2021 and had a diagnosis of obesity or a body mass index of 30 or higher.

The PBM excluded patients using medications for type 2 diabetes, for which these drugs were originally developed. The mean age of patients included in the analysis was 46.5 years, and 81% were women.

Last year, Prime released data showing that 32% of patients were still taking a GLP-1 weight-loss drug 12 months after their initial prescription. The new data shows that overall, for all drugs included in the study, only about 15% were still taking their medication after two years.

For Wegovy, 24.1% of patients continued their treatment for two years without a break of 60 days or more, compared with 36% who continued taking the drug for a full year. With Ozempic, which contains the same active ingredient as Wegovy – semaglutide – 22.2% of patients continued to fill their prescriptions after two years, compared with 47.1% who had used it for a year.

Older GLP-1 drugs fared less well. After two years, only 7.4% of patients were still taking Novo’s Saxenda, a less effective weight-loss drug that some health plans require patients to try before newer GLPs like Wegovy or Eli Lilly’s Zepbound.

In the analysis, 45% of patients were taking Ozempic or Wegovy. The rest were taking Saxenda or Victoza, both based on liraglutide, Rybelsus, an oral version of semaglutide, or Lilly’s Trulicity (dulaglutide).

The analysis also found that 26% of patients switched GLP-1 drugs mid-treatment, possibly due to shortages or changes in insurance coverage, according to Dr. Patrick Gleason, assistant vice president for health outcomes at Prime/MRx and co-author of the analysis.

Novo and Lilly have been unable to meet the unprecedented demand for new drugs.

NOBODY REALLY KNOWS

In a statement, Novo Nordisk cited several limitations to the analysis. It noted that Wegovy was not launched until June 2021, midway through the study period, and it was not immediately covered by insurance. Additionally, Ozempic is not approved for weight loss, which may affect patients’ coverage and persistence in treatment, the Danish manufacturer said.

The company said it “does not believe these data are sufficient to draw conclusions about overall patient adherence and persistence to various GLP-1 medications, including our treatments.”

The new clinically tested GLP-1s have helped people lose more than 15% of their weight by suppressing appetite and promoting feelings of fullness. They are now being tested for a host of other health benefits that could improve insurance coverage.

In March, Wegovy was approved in the United States to reduce the risk of stroke and heart attack in overweight or obese adults.

The analysis did not track long-term use of Lilly’s Mounjaro and Zepbound, which were launched after the study’s starting point. Eli Lilly declined to comment on the overall results.

Prime/MRx did not ask patients why their prescriptions were stopped. Gleason said it was likely a combination of side effects such as nausea and vomiting, out-of-pocket costs and supply shortages.

Some patients may decide to stop treatment after successfully losing weight, doctors say. Other studies have shown that most patients who stop GLP-1 treatment typically regain most of their weight.

“No one really knows how long you should take these drugs,” said Dr. Walid Gellad, a professor of medicine at the University of Pittsburgh who studies medication adherence.

According to Dr. Kumar, some clinics and telemedicine services do not properly screen patients or provide adequate nutrition and exercise coaching, leading to poor outcomes and patient dropouts.

Prime/MRx is owned by 19 U.S. Blue Cross and Blue Shield health insurance plans and manages pharmacy benefits for approximately 38 million people.

Dr. David Lassen, PBM’s chief clinical officer, called the steady decline in persistence two years after treatment began a concern.

“It’s not a stabilization, it’s a slight deterioration,” he said. “It’s really about sustainability of weight loss in order to get long-term results.

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