Managing Drug Spend

Managing Drug Spend

Employers feel the side effects of drugmaker control over Wegovy, Ozempic costs - POLITICO

Interesting article on how employers are trying to manage the high cost of new drugs. In comparison to the per-person costs of some of the newest specialty drugs these are relatively cheap, but the broader need will hit more programs and initially drive up spending.

It will be interesting to see studies on how specific levels of weight loss are correlated with offsetting reductions in hospital and chronic condition spending. While this can help with overall cost management in major medical and MA-PD plans, the story will be different for standalone PDPs which will absorb all drug costs while the offsetting medical reductions accrue to the FFS program. Medicare doesn't allow for coverage of weight loss drugs but many Medicare beneficiaries are expected to have access to these drugs due to other conditions. 1 in 4 Medicare beneficiaries with obesity could get Wegovy despite coverage ban | The Hill

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