Is the rise of GLP-1 usage affecting long-term affordability?

The average total payment per user for GLP-1 medications more than doubled for adults who don’t have diabetes from 2017 to 2022. This comes from a new Northwestern University study that says the findings raise questions about the long-term affordability of drugs that many patients may take for an extended period of time.

Those questions became even more relevant earlier this month when Medicare launched a temporary program that gives millions of eligible seniors potential access to GLP-1s for a flat $50 monthly copayment.

“Higher total costs of GLP-1 drugs might drive up taxes and increase insurance premium payments both for people taking GLP-1s and those not,” said study author Dr. Michael Hammond, a recent graduate of the internal medicine residency program at Northwestern’s McGaw Medical Center.

See also: U.S. healthcare affordability falls to lowest level since 2021

The scientists found that between 2017 and 2022:

• Average total payments per patient increased 157% among adults without diabetes and 36% among those with diabetes.
• Despite rising total payments, average out-of-pocket payments per patient declined 26% among adults without diabetes and 39% among those with diabetes.
• GLP-1 use increased 643% among adults without diabetes and 230% among adults with diabetes.
• Semaglutide became the dominant GLP-1 drug by 2022, accounting for 54% of usage among adults with diabetes and 65% among adults without diabetes.
• As spending on GLP-1s continues to grow, the discussion about who foots the bill extends beyond those taking the drugs, the Northwestern scientists said.

“On the commercial side, employers and insurers facing higher drug spending tend to pass it through in the form of higher premiums, higher deductibles or tighter rules,” said study author Xiaoning Huang, assistant professor of medicine in the division of cardiology at Northwestern University Feinberg School of Medicine.

“On the public side, it shows up as higher Medicare and Medicaid spending funded by taxpayers, and some state Medicaid programs have started dropping coverage under budget pressure,” Huang added. “So, the bill ultimately lands on premium payers, taxpayers and, in some cases, on patients who lose coverage or face new hurdles.”