Many GLP-1 patients drop the drugs before seeing meaningful health benefits, one study finds

Glucagon-like peptide-1 (GLP-1) agonists offer significant promise to patients with obesity, and newer drugs can help them shed more than one-quarter of their body weight in some cases. But many adults in the US who have this chronic disease aren’t staying on GLP-1s long enough to see a “clinically meaningful health benefit,” a recent study from Blue Health Intelligence (BHI) and the Blue Cross Blue Shield Association found.

Some 58% of patients discontinue these medications within 12 weeks, according to the findings, which are based on data from more than 170,000 commercial health plan members dating back to 2014. Research has shown patients taking GLP-1s should “complete at least 12 weeks of continuous treatment” in order to see clinically meaningful results, i.e., at least a 5% weight loss, according to the study.

Most patients in the study (79%) were female, and 42% lived in the Northeast. Over half of the patients received their prescription from a primary care provider, and nearly two-thirds were categorized as “low” for social vulnerability, which is a metric that assesses a community’s vulnerability through external factors like sociodemographic status.

The study states barriers like cost, transportation, and language as factors may inhibit some patients’ ability to continue GLP-1 medications. Ongoing shortages of GLP-1 drugs may also hinder access.

A separate paper recently published in JAMA found 26% of patients discontinued GLP-1s within three months, while about 37% stopped treatment within a year.

All about adherence. Lack of adherence to medications is a common problem across the healthcare industry; the CDC estimates that half of US patients with chronic illnesses stop taking their medications within a year.

Some 74% of US adults have overweight, per the CDC, including 42% who have obesity. More than 5 million prescriptions for Ozempic, Mounjaro, Rybelsus, or Wegovy (all GLP-1s) were written for weight management in 2022, a 2,082% increase from 2019, Healthcare Brew previously reported.

In the case of GLP-1s, non-adherence could be due in part to pharmacists or prescribers not setting realistic expectations with their patients, said Louis Zollo, VP, national pharmacy practice leader with benefits consulting firm Segal. Whereas patients taking antibiotics typically see a “quick, demonstrable effect,” GLP-1 treatment may be “drawn out over weeks and months and potentially years,” Zollo told Healthcare Brew. “If you’re not prepared for that, you may think, ‘Well, this isn’t working right.’”

Not a ‘drug-only’ solution. The BHI findings can help health plans and drug manufacturers as they think about how to design effective weight loss programs incorporating GLP-1 medications, Zollo said. The study found, for example, that patients who were prescribed the medication by an endocrinologist or obesity medicine specialist were more likely to continue taking it for longer compared to those who saw a primary care provider. With this in mind, patients may have a better chance of success if a specialist is involved early on in the process, Zollo suggested.

Zollo stressed that he doesn’t see GLP-1 medications as a “drug-only solution,” and said some patients may need additional counseling in other areas such as nutrition or fitness to see meaningful results.

Virtual healthcare provider Omada Health expanded its GLP-1 care track earlier this year with additional exercise programming to help patients deal with muscle mass loss that often occurs when taking these medications, Chief Medical Officer Carolyn Jasik told Healthcare Brew via email. She noted there’s “no silver bullet” for weight loss, and said Omada’s belief is “medication alone won’t sustain outcomes,” no matter the condition.