Four Important Practices Amid GLP-1 Medications Reshaping Healthcare
Nicole Faucher provides leadership for Clearway Health’s executive team, oversees strategic, operational and financial performance.
As a leader in healthcare solutions looking to help hospitals and health systems improve access to advanced specialty medications, I can attest to the ongoing growth and evolution within the pharmaceutical market.
I think the current obesity specialty pharmacy market offers particularly relevant lessons for business leaders on how to protect market share in a rapidly changing and competitive marketplace.
Obesity has been on the rise.
Obesity prevalence has been steadily rising in the U.S. over the past twenty years. Characterized by a body mass index (BMI) of 30 or higher, obesity can be caused by genetic, environmental, lifestyle or other factors.
Although obesity has a high prevalence (about 41.9% on average), it is not recognized as a chronic disease by all providers; this often leads to underdiagnosis and under-treatment. Yet, over 71% of patients have discussed weight with their healthcare provider in the past five years, among which only 51% were diagnosed with obesity and only 24% received follow-up care (appointment or televisit) related to weight management. Obese patients are more likely to have multiple comorbidities; this can have a profound negative impact on health and be an economic burden on the U.S. healthcare system.
Historically, patients with obesity received treatment from a hospital or healthcare system. Treatment options offered include lifestyle modification programs (dietary adjustment/exercise), endoscopic procedures or bariatric surgery depending on the patient’s BMI and underlying conditions.
Emerging GLP-1 medications are changing the healthcare landscape.
GLP-1 medications have emerged as an effective alternative treatment option in recent years and have seen a significant increase in adoption among providers and patients. According to Cleveland Clinic, "GLP-1 agonists are a class of medications that mainly help manage blood sugar (glucose) levels in people with Type 2 diabetes." Some GLP-1 agonists can also help treat obesity by slowing stomach emptying and increasing a patient’s sense of fullness.
It is projected that around 15 million obese patients will be prescribed GLP-1s by 2030. While promising, the GLP-1 medications can come with a high out-of-pocket cost if not covered by insurance. In addition, patient access may be difficult as available inventory of GLP-1 medications has been inconsistent or scarce in some areas.
Health systems are facing growing competition in caring for the obese patient population. Various healthcare companies and business ventures are expanding their reach to patients through virtual and in-person care models, which is creating additional competition to traditional health systems.
Here are four important practices I think health systems and relevant business leaders should consider to protect market share from new market entrants providing direct-to-consumer programs:
1. Research the competition.
To best understand the vastly changing market landscape, it’s important to research and know the competition. For example, in today’s obesity healthcare market, there are three new entities to follow:
• Retail pharmacy partnerships. For example, Novo Nordisk recently teamed up with CVS Health on an education and nutrition coaching program for people taking anti-obesity meds. The weight loss program is supported through virtual and in-person clinics.
• Direct-to-consumer manufacturers: Companies such as Eli Lilly have launched website platforms to connect patients seeking obesity treatment to doctors and dieticians. Patients are paired with third-party mail-order pharmacies for prescriptions and providers through a virtual medical weight loss clinic.
• Fitness and wellness companies: A few leading telehealth providers and weight loss companies are offering collaborative services to screen patients and begin GLP-1 treatment. Both Weight Watchers and Ro are offering a monthly subscription plan.
2. Consider challenges and look for opportunities.
Current market trends present both opportunities and challenges to health systems wanting to ramp up a weight management program and gain a competitive advantage.
In order to capture the opportunities, health systems need to respond to the increase in demand from patients. Their challenges include limited bandwidth from care teams to diagnose and manage patients; growing GLP-1 treatment posing a threat to existing surgery revenue; increased health expenses from employee health plans; competition from other market players in caring for obese patients; and access barriers to these medications caused by limited supply.
3. Invest in staff.
Healthcare staff are a hospital’s greatest asset. Many health systems continue to struggle with limited staffing capacity which may impact access, screening and treatment for patients. Health systems may consider partnerships or ensure enough support and training are in place to avoid burnout and unhappy employees.
4. Fill the gaps with a focus on innovation.
Study the competition and, if necessary, fill in the gaps with innovative solutions or partnerships. A health system’s strength its the ability to provide coordinated and integrated care for patients.
A common problem in the healthcare industry when launching a weight loss program is the lack of a systematic approach to identifying patients who may benefit from GLP-1 medications. By leveraging integrated care teams and designing a system-wide screening and triaging care pathway, health systems can increase their ability to care for this patient population.
Protecting market share is crucial for business survival.
Protecting market share is vital to the survival, longevity and success of a business. As more non-traditional healthcare service providers enter the space and additional medications are approved, it will be interesting to watch how health systems engage and respond to the new market dynamics.
I foresee current healthcare systems having a significant advantage. However, decisive decision-making, effective execution and agile responsiveness will be necessary to better serve patients and remain competitive in this volatile marketplace.
To read the full published article in Forbes Business Council, click here.