People are less likely to take their GLP-1s when they cost more

A recent investigation reveals that patients are less likely to adhere to their GLP-1 weight loss medications when faced with high out-of-pocket expenses. Conducted by researchers at the University of Georgia, the study examined adherence among 8,914 participants who began taking GLP-1s for weight loss and had continuous insurance coverage for a 1.5-year period. The analysis categorized GLP-1 costs into five brackets: $0-$21, $22-$43, $44-75, $75-168, and over $168.

Even at the lowest cost tier, medication noncompliance was high, with three-quarters of patients discontinuing their GLP-1 within a year of their initial prescription. However, researchers observed a significant decline in adherence once monthly out-of-pocket costs surpassed the $75 mark, reaching more than 80%. Lead author Eunhae Shin, an assistant professor of health policy and management, was surprised to find that adherence remained relatively consistent until this financial threshold, despite higher costs generally being associated with lower adherence.

The study also reveals that various factors contribute to low adherence, such as physical side effects or insurance-related issues like mid-year policy changes, prior authorization requirements, or step therapy. While the study did not directly measure these factors, Shin suggests they play a role in medication adherence. Out-of-pocket costs have a significant impact, with the key takeaway being that financial barriers matter.

The study found that patients paying $168 or more in monthly costs had the lowest adherence rate, around 17%. These individuals were more likely to reside in Southern states and have high-deductible insurance plans. Previous research indicates that low-income populations are more likely to enroll in plans with high-cost sharing and low premiums, meaning they often bear the full cost of GLP-1 medication until their deductible is met.

High deductibles, which can be several thousand dollars, can lead to lower medication adherence for vulnerable populations.

Obesity is associated with an increased risk of heart disease, type 2 diabetes, high blood pressure, and other chronic health conditions. While short-term financial barriers to weight loss medications may be significant, Shin hopes future research will demonstrate the long-term economic benefits of these medications. By potentially reducing emergency department visits and hospitalizations, GLP-1 drugs could lead to cost savings in the long run.