What you need to know about GLP-1s
You’ve asked, and we’ve answered - your top questions about how Omada can help with your strategy for addressing GLP-1s.
By Wei-Li Shao, President, Omada Health
What do Hollywood, TikTok, and the chronic care industry have in common these days? The increased conversations around GLP-1 medications, such as Ozempic©, Wegovy©, Mounjaro©, and Trulicity©.
In case you’re one of the few that don’t know what I’m talking about, GLP-1 stands for Glucagon-like-peptide 1 agonist and is a class of medications that improves blood sugar control with associated weight loss and long-term cardiovascular benefits. GLP-1s are part of a group of hormones that affect metabolism. When blood sugar levels rise these drugs help the body keep blood sugar levels in range. While GLP-1 drugs were first approved to treat type 2 diabetes in 2005, the class of medications have become more popular in recent years, especially as Wegovy (semaglutide) was approved for weight loss in June 2021. More recently the interest has skyrocketed due to mentions of the drug in pop culture.
While we could chat about the medical pros and cons of this drug class for a while, I’m here to answer commonly asked GLP-1 questions from our health plan, employer, and benefits consultants partners.
Q: Does Omada plan to prescribe GLP-1s?
A: GLP-1s for obesity are a needed clinical breakthrough, and they offer a much safer and lower risk option than advanced obesity treatments, such as bariatric surgeries, to individuals in clinical need for it. At this time, Omada does not plan to add physician support for GLP-1 prescriptions to our program. In the past, we’ve tested prescription titration for other chronic conditions and our members let us know that they prefer to work with their PCP and health system to manage prescriptions.
Q: What is Omada's position and clinical stance on these drugs?
A: While there is initial evidence that GLP-1s can be a game-changing medication for the right patient in the short-term, there is still a significant shortage of research on the long-term risks and benefits of staying on this class of drugs. What we do know is that all members, both those who take GLP-1s and those who don’t, can benefit from the effects of lifelong lifestyle change. Keeping affordability in mind, and given that the FDA clearance for these medications includes prescribing them alongside a reduced calorie diet and increased physical activity, we believe these medications need to be coupled with an evidence-based behavior change program. This also ensures that those who can first benefit from a lifestyle change program, start there before advancing to more invasive treatments. This is how we do right by our members and our community.
Q: How are you supporting members who are taking GLP-1s?
A: At Omada, we will continue to do what we have done for over the past decade - support members' choices for managing their health, whether that’s following a paleo, keto, or other diet, taking on a new exercise regimen, using a CGM, or taking GLP-1s.
If our members choose to use GLP-1s or inquire about it, we encourage them to reach out to their PCP for a thoughtful discussion. If our members are taking GLP-1s, to manage their weight and/or diabetes, our care team can provide crucial support for them to experience the full clinical effectiveness of the medication. GLP-1s should be prescribed alongside diet and exercise and supplemented with a behavior change, science-backed approach.
We plan to train our coaches and specialists to deliver our program offerings that consider reduced calorie diets and side-effect management for individuals who are taking GLP-1s. We’re also providing members with resources they can use and tools to download their relevant data from the Omada program to share with their PCP to inform future treatment plans. In particular, we’re here to support our members as they maintain their weight loss when or if they discontinue the medication.
Q: How can customers utilize the Omada program to help aid and inform preauthorization decisions for GLP-1 prescriptions?
A: Improving patient outcomes is a priority at Omada, and we also know that in doing so, we deliver value and savings to employer groups and health plans. We understand the enormous cost that the utilization of GLP-1s could add into the system if not handled thoughtfully. As a strategic partner, we’re here to help health plans, PBMs, employers, and health systems roll out these medications responsibly and in a manner consistent with appropriate coverage and prior authorization policies including but not limited to any step-therapy requirements, please reach out to your Omada representative for more details or contact us online.
While the increased demand and popularity of GLP-1s may seem overwhelming for employers, health plans, and benefit consultants, we want all our customers to know that we’re here as a partner to educate and provide value as they navigate this new and exciting space.