hHaving insurance coverage alone doesn’t guarantee that people can afford or would be willing to pay continuously for chronic disease drugs like Ozempic, a new large-scale study finds.
Looking at insured patients with type 2 diabetes and heart failure, the researchers found that people with higher prescription quotas were less likely to be on glucagon-like peptide-1 (GLP-1) receptor agonists and GLP-1 inhibitors consistently. sodium-glucose cotransporter 2 (SGLT2i) two classes of drugs that produce additional long-term benefits compared to previous treatments, but are also more expensive.
For example, people with high quotas, defined as over $50, were about 50 percent less likely to adhere to GLP-1 drugs like Ozempic and Trulicity than those with low quotas, according to the study published in JAMA. defined as under $10. Network open Thursday.
With SGLT2i drugs like Jardiance and Farxiga, people with high odds were about 30 percent less likely to adhere than those with low odds.
The findings, based on data from more than 94,000 people from 2014 to 2020, highlight the barriers people face in accessing medicines.
An earlier study estimated that about 80 percent of US adults with type 2 diabetes would meet current criteria for taking a GLP-1 or SGLT2i drug, but in recent years, only 9 percent used them. This study also suggests that even if patients are covered and start taking the drugs, high copays could prevent them from using them regularly.
It’s another reminder of why we must address the skyrocketing cost of drugs for these patients, said Utibe Essien, co-first author of the new study and an assistant professor of medicine at UCLA.
In addition to helping people with diabetes manage blood sugar levels, the two drug classes have been shown to improve people’s cardiovascular outcomes over the long term, so lack of medication adherence could mean missing out on those benefits, Essien said. .
The study covers a time before Wegovy, an Ozempic-like GLP-1 drug that treats obesity, was approved in 2021. As more obesity drugs enter the market, access issues could be further aggravated.
Medicare doesn’t cover weight-loss drugs, and private insurance coverage is unpredictable, since the drugs have long been seen as useful for cosmetic rather than medical purposes. The study suggests that even as more insurers cover obesity medications, the amount patients have to pay out-of-pocket could still significantly affect whether they continue to take treatments.
With drugs like Wegovy showing significant effects on weight loss, lack of access has led people to seek out risky alternative sources such as compound pharmacies or websites where they order what appears to be the underlying chemical for mixes by pushing the Food and Drug Administration to warn this week about some off-brand forms of the drugs.
The authors defined medication adherence as taking medication on 80% or more covered days in a year. Among people with low quotas, 72% of those taking GLP-1 medications adhered and 77% adhered to SGLT2i medications, compared with 60% and 73% among people with high quotas.
Of course, factors other than payments, such as side effects, can affect adherence. GLP-1 drugs often cause nausea, vomiting and diarrhea, particularly in the first few weeks. This study shows that even with low payments, not all patients stick to these drugs.
Although the study did not examine medication adherence among the uninsured, the authors note that even among those with health insurance, co-pay variability was associated with decreased medication adherence. which can be even more pronounced among those who are underinsured. or uninsured.
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