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Drugs, Diseases, and the Managed Care Impact

(D2) “Pound for Pound” Assessment of Anti-Obesity Medications, Coverage Policies, and Financial Considerations

Tuesday, October 15, 2024
10:15 AM – 11:30 AM PT
Location: 112
CPE
ACPE UAN:0233-0000-24-046-L01-P | Contact Hours: 1.25 | Activity Type: Knowledge-based
Until recently, anti-obesity medications (AOMs) have only produced modest and short-term weight loss with limited long-term safety data. The Food and Drug Administration (FDA) approval of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for the treatment of overweight and obesity and overweight has shown heightened interest from patients, clinicians, and payers due to recent data showing significant weight loss and reductions in other comorbid outcomes. Payer organizations must evaluate the long and short-term financial implications of covering AOMs and determine appropriate clinical management strategies. Clinicians are navigating patient-centered care focused on health outcomes related to obesity and other comorbidities with ongoing drug shortages. This session will briefly overview AOMs, discuss recent expanded indications, and look ahead at the pipeline. Additionally, this session will provide real-world perspectives from a clinician and share one Medicaid program’s coverage experience and lessons learned.

Learning Objectives:

At the completion of this activity, participants should be able to:
  1. Discuss the clinical data, comparative effectiveness, and long-term outcomes for anti-obesity medications to understand the guideline recommendations for their place in therapy.
  2. Explain the factors clinicians consider when prescribing anti-obesity medications that impact managed care decision-making.
  3. Describe the clinical management considerations for anti-obesity medications for payers including potential strategies for managing off-label use.