The Rising Costs of New Obesity Drugs

Oct 30, 2014
Obesity is estimated to drive $270 billion in additional healthcare spending each year.
Tags
  • Obesity
  • Diabetes
  • Osteoporosis
  • High Blood Pressure/Heart Disease
  • Cancer

With its approval in September, Contrave® (naltrexone HCI and buproprion HCI) became the latest in a growing line of drugs to treat our nation’s expensive weight problem. Contrave is estimated to cost between $1,200 and $1,600 per year.

The Need to Curb Obesity

Obesity is already taking a heavy toll on our healthcare system. It is a common risk factor for many of the costliest diseases – diabetes, osteoarthritis, hypertension, heart disease, reflux disorders, sleep disorders and several forms of cancer, including esophageal, colorectal, breast, endometrial and kidney cancers.

Obesity is estimated to drive $270 billion in additional healthcare spending each year.

The adult obesity rate in the U.S. is nearly 35% – more than 1 in 3 adults or nearly 79 million people – as measured by their body mass index (BMI). By 2030, the rate is expected to rise to 42% of the overall population.

Medication Risks

Weight loss drugs, when used in conjunction with exercise, diet and other lifestyle modifications, have the potential to help severely overweight or obese individuals achieve healthier outcomes. However, many of these medications have also shown the potential for abuse or over-use. In the past, some drugs have been withdrawn after being linked to heart problems, stroke or death. The Food and Drug Administration (FDA) now requires manufacturers to provide additional data in an effort to prevent approval of drugs that cause such problems.

Ensuring Safety and Savings

Express Scripts implements prior authorization programs for these medications to ensure their safe and appropriate use. National spending on these drugs historically has been fairly low, but it has been rising recently. As of August 2014, utilization of obesity drugs has increased nearly 21% from the same time last year. Costs per prescription are also rising as physicians increasingly prescribe newer, more expensive medications.

With the approval of Contrave, the upward trend is likely to continue.

Reducing the U.S. obesity rate is important for the health of the nation, but we also need to ensure that medications are used safely and effectively so that patients and plan sponsors achieve the outcomes that these drugs promise.

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