Real Chemistry’s Latest IRIS Report Reveals Higher Costs to Consumers of GLP-1 Agonist Treatments Obtained in “Gray Market” Vs. Through Traditional Healthcare Providers

July 23, 2024 at 09:40 AM EDT

Online providers and medical spas are charging consumers more than traditional healthcare channels

IRIS by Real Chemistry today released its second market-view report, “From Cost to Value: The Economic Impacts of GLP-1 Agonists on U.S. Healthcare.” The immersive report highlights the growing economic impacts of obesity and the GLP-1 agonist market on the U.S. healthcare system. The forecast predicts that the increase in uptake of these medicines will require the U.S. healthcare system to develop innovative financial models to treat obesity over the short and long-term.

“From groundbreaking consumer demand to the emergence of medical spas and online providers, the forces that are driving the U.S. obesity and GLP-1 agonist market are creating challenges for industry stakeholders that are coming from both within and outside of the healthcare system,” said Rita Glaze-Rowe, President of Transformative Healthcare Markets at Real Chemistry. “As obesity continues to impact nearly 70% of the American population according to the CDC, understanding the treatment options for this disease and the economic implications of this market are crucial as we all work toward sustainable patient outcomes.”

The report reveals the concerning trend of consumers purchasing GLP-1 agonists through a “gray market,” consisting of online providers and medical spas. While these entities offer the coveted medicines at presumable lower costs and added convenience, IRIS reveals that consumers often pay higher costs for these obesity treatments than if they received them through their healthcare providers as covered by health insurance.

Additional findings from the report include:

The use of online providers, compound pharmacies and medical spas continues to increase, leading to commercially insured consumers, in some cases, paying two or three times more compared to traditional healthcare provider engagement and reimbursement.

This creates “blind spots” for healthcare stakeholders and industry professionals due to lack of data visibility (e.g., claims) and aggregated reporting.

Polarizing coverage decisions have occurred as insurers/employers and policymakers grapple with the perceived cost of GLP-1 agonists in treating obesity. However, the real question should be, “Can we afford not to cover?” The IRIS budget impact model found that costs for non-treatment of obesity could exceed the cost to treat by as much as $31.47 billion in the coming years.

IRIS analysis found that more than 80% of claims for GLP-1 medicines are ultimately approved by insurers. This is in stark contrast to the public perception that commercial insurance is severely restricting or will not cover GLP-1 agonists indicated for obesity. IRIS has observed improving access trends and approval rates among individuals who are commercially insured.

“We have seen that costs associated with GLP-1 agonists are continuing to rise, and cost-based decisions are being made by public and private insurers, as well as employers as utilization increases and organizations work to manage or contain costs,” added Glaze-Rowe. “But there are many variables involved that we can’t see or track via claims data and traditional reporting mechanisms. It is important to acknowledge and begin to plan for more integrated value metrics within this market as the potential population health benefits will require a new lens and integrated value frameworks.”

The report calls for healthcare policymakers and consumers to recognize the vulnerabilities introduced by the emerging “gray market” and promotes informed decision-making between consumers and their physicians, as well as appropriate management of medicines and behavior changes. The visibility and evidence generation that will be derived from this approach will benefit all healthcare leaders in improving overall health and reaching a more cost-effective state for GLP-1 agonists within the obesity market.

IRIS by Real Chemistry is an insights-as-a-service platform providing U.S. market-level intelligence for the obesity market. The platform launched in April 2024 and is tracking seven distinct dimensions of the U.S. obesity market (inclusive of all anti-obesity medicines). Leveraging AI, Real Chemistry’s billions of proprietary data points, and expert analysis, IRIS delivers immersive intelligence to help business leaders navigate transformative market events and innovations. IRIS is available through an annual licensed dashboard, market-view reports produced every other month, and other formats in near real-time.

The report’s insights were generated through a methodology that included systematic literature reviews, qualitative stakeholder interviews and development of a budget-impact model to benchmark current and future cost implications for the U.S. obesity market.

About IRIS by Real Chemistry

The platform, reports and associated website page(s) are intended for U.S. audiences and organizations with operations in the U.S. The analysis is conducted by Real Chemistry subject matter experts and is independent and not representative of or sponsored by clients. Visit www.realchemistry.com/transformative-healthcare-markets for more information.

About Real Chemistry

Real Chemistry is a trusted partner to the world’s most successful life sciences and healthcare companies. As a leading provider of AI-powered audience analytics and insights, we help the healthcare industry better understand, reach and engage patients and professionals using bold ideas to create human-centric healthcare experiences. Anchored by our culture of innovation and boundless creativity, our 2,000+ experts across the life sciences, marketing communications and technology enable modern medical therapies and those they were designed to help, meet and exceed their potential.

View source version on businesswire.com: https://www.businesswire.com/news/home/20240723550871/en/

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Real Chemistry’s Latest IRIS Report Reveals Higher Costs to Consumers of GLP-1 Agonist Treatments Obtained in “Gray Market” Vs. Through Traditional Healthcare Providers

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