Real Chemistry’s Latest IRIS Report Reveals Higher Costs to Consumers of GLP-1 Agonist Treatments Obtained in “Gray Market” Vs. Through Traditional Healthcare Providers
23 Julio 2024 - 8:40AM
Business Wire
Online providers and medical spas are charging
consumers more than traditional healthcare channels
IRIS by Real Chemistry today released its second market-view
report, “From Cost to Value: The Economic Impacts of GLP-1 Agonists
on U.S. Healthcare.” The immersive report highlights the growing
economic impacts of obesity and the GLP-1 agonist market on the
U.S. healthcare system. The forecast predicts that the increase in
uptake of these medicines will require the U.S. healthcare system
to develop innovative financial models to treat obesity over the
short and long-term.
“From groundbreaking consumer demand to the emergence of medical
spas and online providers, the forces that are driving the U.S.
obesity and GLP-1 agonist market are creating challenges for
industry stakeholders that are coming from both within and outside
of the healthcare system,” said Rita Glaze-Rowe, President of
Transformative Healthcare Markets at Real Chemistry. “As obesity
continues to impact nearly 70% of the American population according
to the CDC, understanding the treatment options for this disease
and the economic implications of this market are crucial as we all
work toward sustainable patient outcomes.”
The report reveals the concerning trend of consumers purchasing
GLP-1 agonists through a “gray market,” consisting of online
providers and medical spas. While these entities offer the coveted
medicines at presumable lower costs and added convenience, IRIS
reveals that consumers often pay higher costs for these obesity
treatments than if they received them through their healthcare
providers as covered by health insurance.
Additional findings from the report include:
- The use of online providers, compound pharmacies and medical
spas continues to increase, leading to commercially insured
consumers, in some cases, paying two or three times more compared
to traditional healthcare provider engagement and
reimbursement.
- This creates “blind spots” for healthcare stakeholders and
industry professionals due to lack of data visibility (e.g.,
claims) and aggregated reporting.
- Polarizing coverage decisions have occurred as
insurers/employers and policymakers grapple with the perceived cost
of GLP-1 agonists in treating obesity. However, the real question
should be, “Can we afford not to cover?” The IRIS budget impact
model found that costs for non-treatment of obesity could exceed
the cost to treat by as much as $31.47 billion in the coming
years.
IRIS analysis found that more than 80% of claims for GLP-1
medicines are ultimately approved by insurers. This is in stark
contrast to the public perception that commercial insurance is
severely restricting or will not cover GLP-1 agonists indicated for
obesity. IRIS has observed improving access trends and approval
rates among individuals who are commercially insured.
“We have seen that costs associated with GLP-1 agonists are
continuing to rise, and cost-based decisions are being made by
public and private insurers, as well as employers as utilization
increases and organizations work to manage or contain costs,” added
Glaze-Rowe. “But there are many variables involved that we can’t
see or track via claims data and traditional reporting mechanisms.
It is important to acknowledge and begin to plan for more
integrated value metrics within this market as the potential
population health benefits will require a new lens and integrated
value frameworks.”
The report calls for healthcare policymakers and consumers to
recognize the vulnerabilities introduced by the emerging “gray
market” and promotes informed decision-making between consumers and
their physicians, as well as appropriate management of medicines
and behavior changes. The visibility and evidence generation that
will be derived from this approach will benefit all healthcare
leaders in improving overall health and reaching a more
cost-effective state for GLP-1 agonists within the obesity
market.
IRIS by Real Chemistry is an insights-as-a-service platform
providing U.S. market-level intelligence for the obesity market.
The platform launched in April 2024 and is tracking seven distinct
dimensions of the U.S. obesity market (inclusive of all
anti-obesity medicines). Leveraging AI, Real Chemistry’s billions
of proprietary data points, and expert analysis, IRIS delivers
immersive intelligence to help business leaders navigate
transformative market events and innovations. IRIS is available
through an annual licensed dashboard, market-view reports produced
every other month, and other formats in near real-time.
The report’s insights were generated through a methodology that
included systematic literature reviews, qualitative stakeholder
interviews and development of a budget-impact model to benchmark
current and future cost implications for the U.S. obesity
market.
About IRIS by Real Chemistry
The platform, reports and associated website page(s) are
intended for U.S. audiences and organizations with operations in
the U.S. The analysis is conducted by Real Chemistry subject matter
experts and is independent and not representative of or sponsored
by clients. Visit
www.realchemistry.com/transformative-healthcare-markets for more
information.
About Real Chemistry
Real Chemistry is a trusted partner to the world’s most
successful life sciences and healthcare companies. As a leading
provider of AI-powered audience analytics and insights, we help the
healthcare industry better understand, reach and engage patients
and professionals using bold ideas to create human-centric
healthcare experiences. Anchored by our culture of innovation and
boundless creativity, our 2,000+ experts across the life sciences,
marketing communications and technology enable modern medical
therapies and those they were designed to help, meet and exceed
their potential.
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