A Balancing Act: Weighing the Benefits of GLP-1s

Our client is one of the world’s largest flooring manufacturers, with over 40,000 employees across the globe. Like many employers, they wanted to know:

“What is the real impact of GLP-1s on diabetes?”  

Specifically, they want to understand whether the investment in GLP-1s has been effective in a) helping their diabetic population of nearly 3,000 employees and members better manage their chronic disease and b) addressing the $40M+ in annual spend for this population.

Six Interesting Findings.

1. Diabetic members are increasingly opting to take GLP-1s. Diabetics with the greatest risk are the ones increasingly adopting GLP-1s. Overall, diabetics on GLP-1s increased 22% year over year from 2022 to 2023, while the number of diabetic members not taking GLP-1s has decreased.
2. As anticipated, Rx spend for GLP-1 users was higher compared to those not on GLP-1s. The per member per month (PMPM) Rx spend for a diabetic member on GLP-1s was over 2.5x the Rx spend for a diabetic member not on GLP-1s.
3. However, medical spend for members on GLP-1s were lower than their non-GLP-1 counterparts. The PMPM medical spend for a diabetic member on GLP-1s was about 40% lower than the medical spend for a diabetic member not on GLP-1s.
4. Diabetic members taking GLP-1s are more consistent in taking their diabetic medication, as evidenced by the increase in the fill rate for prescribed insulins, Metformin, and inhibitors by this group.
5. At the same time, GLP-1 users have fewer Rx prescriptions for other comorbidities. Script counts for cardiovascular conditions and antidepressants decreased among this group.
6. Risk scores improved for diabetic members taking GLP-1s. Artemis Risk Scores provide a relative numerical indicator of risk that considers eligibility, medical, and pharmacy data and can be used as a predictor of better or poorer health outcomes for a cohort of members. When compared against the average risk score for a diabetic member, diabetic members not taking GLP-1s are riskier than average, while those taking GLP-1s were less risky than average—and, by a wider margin. GLP-1 users were also less risky than in the prior year, while non-GLP-1 users became riskier.

The jury is still out on the long-term effects and results of GLP-1s, but early signs indicate stabilization for diabetic members with respect to cost and clinical outcomes. While prescription drug costs are going up, total medical and prescription drug spend is trending down.

The decision.

The analysis findings helped our client decide to continue with offering GLP-1s as a benefit for their diabetic members, with a cost-sharing component.

What employers need to know.

Although not enough to offset the high cost of the GLP-1 drugs themselves, GLP-1s are having an impact on cost. The equation would start to balance if employers were able to keep the costs of GLP-1s down. Exploring options such as working with a pharmacy benefit manager, looking for alternative methods of sourcing or introducing a cost sharing plan are examples of ways to shave down expenses to realize savings sooner.

To understand how Artemis can help you tackle your GLP-1 strategy, reach out to artemis@nomihealth.com.

About the analytics

Our client relied on their analytic advisor team at Artemis to study the year-over-year trends from 2022 to 2023 for diabetic members taking GLP-1s compared to diabetic members not taking GLP-1s. The findings highlighted promising trends in behaviors, costs, and health outcomes.