Posts in category: Rx Insights

The weight loss drug market is evolving rapidly as pharmaceutical companies advance their clinical trials for both oral and non-oral GLP-1 formulations. As Biopharmadive recently noted in an article, “The obesity drug race is far from over, with a plethora of companies vying for a piece of what’s expected to become a huge market in the years ahead. Analysts project that “incretin” drugs, like Novo’s Wegovy and Lilly’s Zepbound, could top more than $100 billion in yearly sales by 2030.” 

While these emerging treatments promise expanded therapeutic benefits for obesity-related conditions as well as improved efficiency in weight loss, they also pose challenges for employer-sponsored prescription plans already experiencing unprecedented utilization and cost increases from GLP-1s.  

Emerging Treatments in Clinical Trials 

These pharmaceutical companies are conducting extensive clinical trials for both oral and non-oral GLP-1 drugs, with each potential treatment still awaiting FDA approval: 

• Novo Nordisk’s experimental oral drug, amycretin, currently in Phase 3 trials, has shown promise beyond weight loss. By targeting both GLP-1 and amylin receptors, it may offer additional benefits for cardiovascular health and metabolic disorders associated with obesity¹.  

• Eli Lilly’s orforglipron, advancing through Phase 3 trials, demonstrates potential benefits for obesity-related complications including fatty liver disease and sleep apnea².  

• Amgen’s MariTide (maridebart cafraglutide), in late-stage clinical trials, is being studied for potential impacts on obesity-related inflammation and metabolic syndrome, with a unique monthly dosing approach³.  

• Other pharmaceutical companies, including Roche and emerging biotech firms, are conducting trials focusing on broader therapeutic applications for obesity-related conditions while improving tolerability⁴.  

The Implications for Plan Sponsors 

As these medications progress through clinical trials toward potential FDA approval, many current injectable users may transition to oral versions, while the improved accessibility could drive new patient adoption. This shift will likely intensify the financial pressure on prescription benefit plans. 

In response to these market dynamics, Benecard continues to develop innovative solutions to help manage rising costs of GLP-1 drugs while ensuring appropriate care. Our comprehensive approach includes specialized plan design features which were previously addressed in our three-part bulletin series “decoding the rising Rx trends.” 

Contact us to explore strategies for managing GLP-1 medication expenses while supporting employee health outcomes. 

Sources: 

“The Race for Oral Obesity Drugs: Multiple Phase 3 Trials Vying for Next-Gen Status,” Fierce Pharma. 

“GLP-1 Market Heats Up as Companies Vie for Next-Gen Obesity Drugs,” Outsourcing-Pharma. 

“Why Amgen’s MariTide Could Rival Eli Lilly and Novo Nordisk’s Obesity Drugs,” Business Today. 

“Four Oral GLP-1 Products in Phase III Trials as Race Intensifies,” Clinical Trials Arena. 

In today’s market if you’re seeing prescription drug trend estimates in the single digits, you should know: those numbers don’t reflect reality. Some trend calculations may focus solely on manufacturer drug price inflation and therefore dramatically understate actual or true prescription benefit trends. To accurately project trends, additional critical factors must be considered:

• Utilization Patterns – Prescription volume increases yearly as population age and chronic conditions become more prevalent and members simultaneously shift to newer, costlier alternatives. Medical advancements allow for earlier diagnosis which drives longer treatment duration and higher utilization.
• Specialty and Non-Specialty Pipeline Impact – New to market drugs typically launch at premium price points as compared to existing products. These treatments often expand the treatable population while commanding unprecedented costs.

The Risk of Underestimating

When these factors are properly weighted, we consistently see trends in the mid to higher teens. When plans understate drug trends, they create severe budget shortfalls. This forces employers to make radical mid-year plan design adjustments or significantly increase contributions or benefit reductions the following year, all while making it increasingly difficult to secure stop-loss coverage in the following year without significant rate increases. 

Looking Ahead

While we can’t control drug prices, we can control how benefits are managed. That’s where Benecard Services is different. Instead of just chasing rebates and managing unit costs, we have aligned financial interests with our clients that focus on getting members the right medications while keeping costs in check. No conflicts of interest ― just patient-centered care that works.

With more specialty and GLP-1 drugs in the pipeline, these trends will only intensify. Contact us today at (800) 734-9528 or talktous@benecard.com to discuss how Benecard is helping employers tackle rising drug trends.