Weighing the Pros and Cons, and Dollars and Cents, of the New Wave of Weight-Loss Drugs

With over 15 years of pharmacy benefit management experience, Jason Peterson is a key member of the clinical team overseeing RemedyOne formulary management, clinical policy development, pipeline reporting and trend analysis of pharmacy benefits for our clients. Jason’s experience is leveraged to identify spend and trend analysis of both pharmacy and medical benefit cost of care and utilization to identify opportunities for enhanced clinical effectiveness and savings. In his previous role as a prior authorization pharmacist Jason provided complete oversight of a prior authorization processing operation at a long-term care pharmacy. He was responsible for providing clinical solutions for pharmacy claim resolution and engagement in cost efficient clinical programs. During this time, Jason developed particular expertise in pharmacy benefits management focused heavily on specialty and medical pharmacy where he provided oversight of clinical policy development, utilization management strategy, formulary management, pharmacy pipeline reporting, therapeutic class and new drug to market review and strategy, client implementation and support, and involvement with P&T and value assessment committees. Leveraging his extensive pharmaceutical experience, Jason also held a lead clinical pharmacist role at a health plan which included development and participation in member- and provider- facing clinical quality programs including STARS and HEDIS measures for all lines of business.
Clinical Pharmacist

See this article by RemedyOne senior manager of formulary development Jason Peterson as it originally appeared in pharmaphorum and read the Goodroot weight loss drug guide it’s based on. 

Obesity rates in the United States have tripled since the 1980s. According to the CDC, a mind-boggling 41.9% of adults were obese as of 2020. Many adults with obesity have a higher risk of developing other health problems, such as heart disease, hypertension, joint pain, and certain types of cancer. 

This is a national health crisis. 

When it was discovered that new diabetes drugs induced rapid and substantial weight loss, it received quite a bit of attention from a population at such risk for obesity. But, as effective as they are, these drugs are not magic. There’s much to consider for patients, providers, and health plans. 

Ozempic is the Headliner 

Of all the drugs being used for weight loss these days, none has gotten more attention than Ozempic. Manufactured by Novo Nordisk, Ozempic is a self-administered injectable diabetes medication in the glucagon-like peptide 1 (GLP-1) receptor agonist class. It mimics a natural substance in the body that is released when we eat and causes the body to reduce blood glucose by producing more insulin. 

Despite the amount of attention it has received, Ozempic is FDA approved only for the treatment of type 2 diabetes and not obesity. However, it has been prescribed for off-label use and was found to be an effective weight-loss drug. 

Not only does Ozempic boost the release of insulin, it slows the release of sugar from the liver, delays digestion in the gut, and reduces appetite, which helps people eat less. 

Wegovy is… Ozempic, But More of it 

Wegovy is exactly the same as Ozempic — same manufacturer, same active ingredient (semaglutide). What makes it “different” is it is administered at a higher dosage and, as a result, is more effective for weight loss than Ozempic. Unlike Ozempic, Wegovy is only FDA approved for weight loss in patients who have a body mass index (BMI) greater than 30 or those with a BMI of 27 with certain other risk factors. 

Because of the perceived interchangeability of Ozempic and Wegovy, some physicians have prescribed both drugs for weight loss. This has resulted in supply shortages that impact patients who need these medications, for diabetes or for weight loss. Further contributing to this shortage is the prescribing of these medications off label to patients. 

Continue reading at pharmaphorum and check out Balancing The Scales: A Comprehensive Guide For Healthcare Payers On The Value & Viability Of New Weight Loss Medications. 


Rebate and Formulary Management

RemedyOne cuts through the complexity of the pharmaceutical world by providing guidance and cost savings to PBMs, Employer Groups, Health Plans, and Third-Party Administrators.
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Rebate and Formulary Management

RemedyOne cuts through the complexity of the pharmaceutical world by providing guidance and cost savings to PBMs, Employer Groups, Health Plans, and Third-Party Administrators.
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