The Battle to Own the GLP‑1 Patient Journey

The useful part

Advertisement The first phase of the GLP-1 revolution was a race to develop better drugs but the next may be a race to control what happens around them. For the past several years, competition in obesity has centered largely on the medicines themselves. Novo and Eli Lilly demonstrated levels of weight loss that changed expectations for what obesity drugs could accomplish.

How it works

• MinuteClinic, a large pharmacy network, pharmacists, CVS Caremark, digital capabilities, and extensive relationships with employers and health plans.
• Anyone who has watched a patient try to obtain a GLP-1 knows that receiving a prescription is only the beginning.
• The health plan or employer determines the pharmacy benefit, often working through a pharmacy benefit manager (PBM) that manages formularies, prior authorization, and other access requirements.
• CVS also works with employers and health plans trying to manage the rapidly growing cost of obesity treatment.
• It works with licensed third-party dispensing pharmacies and can connect patients with care when they need a provider, while also supporting savings, home delivery, and retail pickup.

What to take from it

Competitors responded with new molecules, combinations, oral formulations, and longer-acting therapies. Yet maintaining very large populations indefinitely on costly pharmacotherapy creates an obvious affordability challenge for employers, insurers, government programs, and patients. First, a patient has to find a clinician and determine whether treatment is appropriate and then comes insurance coverage.

Example or evidence

• Primary care organizations, health systems, and specialized obesity practices already possess something many newer entrants are trying to build: a trusted longitudinal relationship with the patient.
• Investors and industry analysts understandably focused on efficacy, tolerability, manufacturing capacity, and which company might have the next blockbuster.
• CVS Health's recent expansion of its weight-management services offers a useful glimpse of this shift.
• In August, the company lowered the price of a MinuteClinic digital weight-loss visit to $29, with no membership or recurring monthly fee.

Details worth keeping

CVS describes the offering as combining an online visit with a licensed clinician, potential same-day medication pickup at ~9,000 CVS Pharmacy locations, and in-person pharmacist support. "Obesity is a chronic disease, and weight regain after treatment discontinuation remains an important concern. That tension makes maintenance one of the most important unresolved questions in the obesity market." There is nothing particularly revolutionary about offering obesity care virtually.

Related coverage

• Labiotech: There is a lot going on in the GLP-1 space, a market that landed $79 billion last year, and could shift significantly in the coming years.
• 5wpr: Study 11 of the 5W Reputation Index looks at how AI engines describe 18 pharma CEOs, and how the GLP-1 shift rewrites all of those profiles at once.