Patient Behavior Key to New Obesity Drugs

Dec 3, 2012
Two recently approved drugs promise to help fight the obesity epidemic, but lifestyle modification programs remain critical to long-term weight management.

Two recently approved drugs promise to help fight the obesity epidemic, but lifestyle modification programs still hold the key for long-term weight management. 

Last week, Express Scripts' inaugural Drug Trend Quarterly provided an update on U.S. prescription drug pricing and use in 2012. In the report, we discussed the potential impact of Belviq® (lorcaserin) and QsymiaTM (phentermine and topiramate, extended release), the two new medications that the Food and Drug Administration (FDA) approved this summer to treat obesity.

How Qsymia and Belviq Work

Both Qsymia and Belviq work by suppressing a patient’s appetite.

Clinical trials have shown promising results, suggesting either drug may help clinically appropriate patients lose a significant amount of weight. In clinical trials, 38% to 47% of patients who were taking Belviq lost at least 5% of their body weight. Similarly, between 62% and 69% of patients taking the recommended highest dose of Qsymia lost at least 5% of their body weight.

The Potential Market for Anti-Obesity Medications

The FDA approved both medications for people who have a body mass index (BMI) greater than 30, as well as for people who have a BMI of at least 27 and at least one other weight-related condition — for example, diabetes or high cholesterol.

As of 2010, more than 72 million American adults had qualifying BMI levels. By 2030, approximately 42% of the overall population will be obese.

In the U.S., no prescription medication has ever been indicated for a greater percentage of the population.

Our Perspective: Successful Weight-Loss Interventions Must Target Patient Behavior

In light of the high cost of these medications and still uncertain benefits for health and productivity, coverage decisions by plan sponsors should be carefully considered. The potential benefits of these new anti-obesity medications need to be compared against their risks and cost.

Although medications may help overweight and obese patients lose weight, obesity remains a multifaceted problem. Restricting calories is key to losing weight in the short term, and increased physical activity is critical for the maintenance of weight loss.

As an advocate for a healthier America, Express Scripts is cautiously optimistic about the possibilities of these and other forthcoming drugs like them, provided they are prescribed appropriately and integrated with other lifestyle-modifying programs that help patients make healthier choices that maintain their weight over time.

In many instances, what stands between doctors’ orders and optimal health outcomes is patient behavior.

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