More than 2 out of 3 people taking a weight loss medication like Wegovy (semaglutide) were no longer doing so after one year, according to an analysis of pharmacy and medical claims data issued July 11 by Prime Therapeutics, a company that manages pharmacy benefits for about 38 million people.
Semaglutide drugs like Wegovy and the diabetes medication Ozempic belong to a class of medications known as GLP-1 receptor agonists. These drugs work by mimicking a hormone called glucagon-like peptide-1, which targets parts of the brain that regulate appetite. The medications also slow the digestive process so people feel less hungry and eat less.
In clinical trials described on the drugmaker’s website, 48 percent of people taking Wegovy by once-weekly injection lost 15 percent or more of their body weight.
So, if semaglutide is so effective in helping people lose weight, why do many people stop taking it?
Weight Loss Drug Shortages Can Be an Issue
People who discontinue medications for weight loss may do so because the drugs aren’t in stock at their pharmacy.
“The medications were not available for a lot of 2022, and even in 2023 we’re running into similar issues — many doses are hard to find anywhere in the United States,” says Fatima Cody Stanford, MD, MPH, an associate professor of medicine at Harvard Medical School and an obesity medicine physician scientist at Massachusetts General Hospital, both in Boston.
Both Wegovy and Ozempic are currently in shortage, according to the U.S. Food and Drug Administration (FDA) website.
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Insurance Denials or High Copays May Put Weight Loss Drugs Out of Reach
Dr. Stanford has also seen cases where insurers initially covered a weight loss medication but then later denied coverage. A person can also run into problems if they lose their job or change their insurance.
“Another factor could be the copay. There is a coupon available that does allow a discounted cost of getting the medication for a finite period of time, but once the initial period is over, the patient is often required to pay more out of pocket,” she says.
Stanford points out that in clinical trials for semaglutide drugs, where cost and access aren’t issues, the adherence rate is high.
In a 16-month trial of semaglutide published in March 2021 in the New England Journal of Medicine, investigators reported that over 94 percent of the participants completed the trial, and 81 percent followed the treatment.
In a Reuters report published July 11, Patrick Gleason, Prime Therapeutics’ assistant vice president for health outcomes and a coauthor of the company’s analysis, stated that although the study didn’t ask patients why they stopped filling their prescriptions, the cost of copays could have been a factor.
Are People Quitting Weight Loss Drugs Because of Side Effects?
Gleason suggested that side effects like nausea and vomiting also may explain why so many people bail on this new generation of weight loss medication.
Gastrointestinal issues are the most commonly reported side effects for GLP-1 drugs, says Stanford. But in clinical trials, side effects didn’t cause a lot of people to drop out, she notes.
In the study mentioned above, only 59 of the 1,306 people (4.5 percent) stopped treatment because of gastrointestinal side effects.
People in the Analysis Were Taking Wegovy, Ozempic, Saxenda, or Rybelsus
For the Prime Therapeutics analysis, researchers looked at pharmacy and medical claims data from 16 million commercially insured members, and limited their analysis to individuals who were newly started on a GLP-1 receptor agonist in the 2021 calendar year.
Participants were required to have an obesity diagnosis prior to this time, a prediabetes diagnosis, or a body mass index of 30 or higher. Individuals were excluded from the analysis if they had a prior diabetes diagnosis or were on diabetes drug therapy. The average age of participants was 47 years old, and 81 percent were women.
Nearly half the individuals were prescribed Ozempic or Wegovy, both of which contain semaglutide. Others were taking Saxenda (liraglutide) or Rybelsus, an oral version of semaglutide.
Overall, only 32 percent of the patients were still taking the medicine for weight loss a year after their initial prescription, and all the patients had insurance coverage for GLP-1 drugs, according to the report.
People Who Stop Taking Weight Loss Medications May Not Know the Pounds Can Come Back
Some patients may have started these medications without any long-term plan to continue or without understanding the need to continue these medications after they achieve their desired weight, says Stanford.
As with many other chronic disease treatments, a person needs to stay on the medication throughout their lifetime to treat overweight and obesity or diabetes or both, says Stanford. Otherwise, the weight can come back.
“That means that if a person successfully sheds pounds, they need to stay on the medication to avoid regaining the weight — some patients are surprised to learn that. For people who can tolerate these medications and are able to get them successfully, I do recommend they continue on the medications for their continued benefits,” she says.
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