In the age of GLP-1s, clinically-guided step therapy can be an effective cost-containment strategy. Learn more about this care delivery approach.
According to a recent survey done with the Obesity Action Coalition, 44% of adults in the U.S. would switch employers to gain coverage for obesity treatment. These results suggest that employees seek support on their weight loss journey, likely driven in part by the rise in popularity of drugs such as GLP-1s.
Many employers are mindful of the need to invest in a weight loss program for their workforce. However, selecting a program that heavily relies on GLP-1 drugs may increase the risk of an employer’s medication utilization costs. Programs that follow a step therapy approach can offer a better financial path.
Step therapy is a cost-management approach to prescriptions by insurers that requires a patient to try a less expensive drug to treat a given condition before “stepping up” to a more expensive option. With drugs used as weight loss treatment, research has shown that GLP-1s are not the most appropriate medication for all patients. With step therapy, providers do not prescribe GLP-1s as the first line of treatment for weight loss–instead, other non-GLP-1 medications are prescribed based on what is clinically appropriate to each patient’s individual needs.
How Found implements step therapy when caring for members
To support sustainable health outcomes and help employers save on medication costs, Found follows this step therapy process:
1) Identify root causes. “By looking at a member’s MetabolicPrint, Found's proprietary tool for assessing medical history, family history, and prior weight loss attempts, in combination with biomarkers, clinicians can get a clue into the root cause of obesity,” explains Rekha Kumar, MD, MS, chief medical officer at Found Health.
2) Prescribe a suitable medicine. Once the root cause of obesity is determined, the best match may be a non-GLP-1 medication. Other times, a brand-name drug or GLP-1 may be the only and best option.
3) Monitor and adjust. Found-affiliated clinicians work with members over time to monitor responses and make adjustments. Depending on a member’s progress, providers may add or swap in other medical options from Found’s medication toolkit as needed.
GLP-1s are not the only treatment for obesity and overweight that leads to success; many taking non-GLP-1 medications for weight loss see results. In fact, 91% of Found members who lost 15% or more of their body weight at 12 months did so without GLP-1 medications. On average, members lose 10% of body weight by 12 months without GLP-1s. Clinical evidence supports the medications Found offers as being highly effective and safe for aiding weight loss, notes Dr. Kumar. Found’s approach to step therapy creates a weight care program that is cost-effective and sustainable for the employer and the employee.
Found is among the largest medically supported telehealth weight care clinics in the country, having served more than 250,000 members to date. Our mission is to help employers build happier, healthier teams by effectively improving employee health through comprehensive, personalized weight care.
Living with obesity in the time of GLP-1s. (May 26, 2023.) Fierce Healthcare. Retrieved May 16, 2024 https://www.fiercehealthcare.com/digital-health/employers-grapple-soaring-demand-obesity-care-benefits
Fischer, M. A., Kesselheim, A. S., Lu, Z., Ross, K. M., Tessema, F. A., & Avorn, J. (2019). Physician Perceptions of Step Therapy Prescribing Requirements. Journal of managed care & specialty pharmacy, 25(11), 1210–1224. https://doi.org/10.18553/jmcp.2019.25.11.1210
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