Recent statistics from the CDC show more than 38 million people in the US have diabetes and up to 9 million of that number as undiagnosed.₁ GLP-1 receptor agonists, such as Ozempic are reshaping the management of Type 2 diabetes and obesity. These medications have demonstrated remarkable effectiveness in improving blood sugar control, as well as cardiovascular and nervous system protective effects₂ and supporting significant weight loss. As a result, the demand for GLP-1 therapies has surged, presenting both opportunities and challenges for health plans.
Impact on Health Plans
With the rising popularity of GLP-1 treatments like Ozempic, health plans must navigate the delicate balance of increasing drug costs and the need to ensure patients have access to these life-changing medications. At the same time, plans must consider the potential long-term savings from improved health outcomes, such as reduced hospitalizations and better chronic disease management. Some plans have also expressed concerns regarding misuse and potentially fraudulent activity related to these medications.
The Role of M3P in Managing GLP-1 Therapies
This is where the Medication Management and Monitoring Program (M3P) becomes crucial. M3P allows health plans to closely monitor the utilization of high-cost medications like GLP-1s, ensuring appropriate use and preventing misuse or over-prescription. Through M3P, health plans can maintain tighter control over medication adherence and outcomes, while also mitigating potential risks such as fraud. This is particularly important with the rising demand for GLP-1 drugs and the complexities they bring to the healthcare landscape.
How Rebellis Can Help
Rebellis Group is well-equipped to support health plans in managing the growing use of GLP-1 therapies. We offer expert guidance on formulary management, medication therapy management (MTM), and compliance strategies. Our data-driven insights, including M3P implementation, allow health plans to balance access, affordability, and outcomes while safeguarding financial sustainability. We also offer a subscription service that analyzes HPMS and regulatory memos, ensuring your team stays up to date with the latest information to support your success.
Partner with Rebellis to optimize your approach to GLP-1 therapies and position your health plan for long-term success. Contact us today to get started at partners@rebellisgroup.com.
Resources:
Comments