Replay - Improving Metabolic Health in a GLP-1 World

With GLP-1 medication utilization skyrocketing, employers are facing a massive financial challenge. While GLP-1s can offer significant benefits to patients, they also carry high discontinuation rates and sizable price tags. How can employers balance cost containment while enabling their members to achieve optimal health outcomes?

During During Health Benefits Administration + Care Delivery: Improving Metabolic Health in a GLP-1 World, Sara Izadi, PharmD (Chief Clinical Officer), Bonnie Hui-Callahan, PharmD, CDCES (VP, Clinical Programs) and Vida Health’s Richard Frank, MD, MHSA (Chief Medical Officer) explored how an integrated approach to cardiometabolic care achieves this balance.  

Check out the highlights below! And if you want to review the full webinar replay, click here.

The True Cost of Cardiometabolic Disease

The addressable market for FDA-approved GLP-1 indications currently sits at about 40% of the United States population. When looking at the data, the financial burden placed on employers becomes staggering. An individual diagnosed with obesity or diabetes spends roughly $21,000 on average. If an employee has both diagnoses, that number can climb to $50,000.

Why Behavior Change Matters

The FDA didn’t anticipate that GLP-1s would be prescribed in isolation. In fact, GLP-1 labels explicitly state that these medications should act as an adjunct to diet and exercise.

A successful intervention requires addressing the root behavioral drivers of cardiometabolic disease. That includes self-monitoring, caloric reduction, and managing emotional eating. Put simply, care management programs that pair clinical oversight with behavioral support create lasting change.

What Differentiates Top-Performing Clinical Programs for Specialty Drug Management?

The most effective specialty drug clinical programs utilize an evidence-based, stepwise approach.

Judi Health and Vida Health partnered to create the Rx Activate program, which addresses this exact need. This high-touch obesity step solution begins with intensive lifestyle, behavioral, and clinical support, enabling patients to get the right drugs at the right time.

Key elements of this integrated approach include:

• Multidisciplinary care teams: Patients gain access to physicians, registered dietitians, behavioral health coaches, and licensed therapists. ‍
• Asynchronous communication: Members can message their care team and receive responses within one to two days. ‍
• Primary care integration: The specialty clinic shares clinical consult notes directly with the patient's primary care physician to maintain continuity of care.

This level of clinical program engagement reduces inappropriate use while giving members the exact tools they need to succeed.

How Can Population Health Programs Demonstrate ROI for Self-Funded Employers?

When evaluating care coordination programs, stakeholders want to see concrete data. Which programs produce measurable results for high-cost therapies and chronic disease management? How does clinical engagement translate to ROI for populations and employer plans?

Rx Activate recently analyzed real-world results from its member cohort. The findings show a comprehensive, member-centric approach drives substantial clinical and financial value.

Key performance metrics:

1. Behavioral success: Over half (54%) of members required no weight loss medication post-enrollment, achieving their goals through behavior change alone. ‍
2. Strategic deprescribing: Of the members who were already on a GLP-1 before enrolling, 29% successfully discontinued their medication after starting the program. ‍
3. Increased adherence: The program drove a 15% increase in medication adherence for those who truly needed pharmacotherapy.

In summation, a program like Rx Activate can deliver significant total cost reduction. Identifying patients who can succeed with behavior change carves them out from the high-cost pharmacy experience entirely. For those who remain on medication, improved adherence prevents downstream medical complications. This dual benefit directly drives clinical program ROI.

Building a Sustainable Strategy

Treating obesity and cardiometabolic syndrome requires a long-term perspective. Handing a patient a prescription without wraparound support system is a failed strategy.

By integrating modern health benefit management with dedicated clinical care teams, employers can control costs and empower their members to achieve optimal health outcomes.

If you want to learn more about the Rx Activate program, or about Judi Health’s approach to clinical programs, contact our team today!