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| Presented By PhRMA |
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| Axios Vitals |
| By Tina Reed · May 04, 2023 |
| Happy Thursday, Vitals readers. Today's newsletter is 995 words or a 3½-minute read. 📆 Mark your calendars: Our annual dealmakers event Axios BFD is heading to San Francisco next Wednesday, May 10! You'll hear from big names in Silicon Valley and beyond on the news and trends driving headlines, markets and deals. The livestream starts at 2pm PT. Register here to join us virtually. |
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| 1 big thing: Employers grapple with the weight loss drug craze |
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| Illustration: Annelise Capossela/Axios |
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| Employers are fielding a surge of demand from their workers for obesity care benefits — specifically, for a buzzy class of weight loss drugs — and it's getting pricey. Why it matters: The drugs — known as glucagon-like peptide agonists, or GLP-1s — have been found to effectively help people lose excess weight, which is tied to a slew of health conditions that can be costly in their own right. - But the drugs themselves — including Novo Nordisk's Wegovy and Saxenda which are approved for weight loss, as well as the diabetes drug Ozempic — aren't cheap, and risk driving employers' and their workers' insurance premiums up.
What they're saying: "When you look at GLP-1s, they now represent a fairly significant amount of the total drug spend," Nadina Rosier, chief product officer and general manager, pharmaceutical solutions for the Health Transformation Alliance, a cooperative of America's largest employers, told Axios. - Semaglutide — sold under the brand names Ozempic, Wegovy and Rybelsus, which is also a Novo Nordisk drug — ranked fourth for total drug expenditures in the U.S. in 2021 at $10.7 billion, up 90% over the year before, according to a study published last year in the American Journal of Health-System Pharmacy.
The big picture: More than 4 in 10 Americans have obesity — up from about 30% in 1999 — and that number is expected to jump to about 50% by 2030. - Experts say these drugs could be transformative because studies have demonstrated they can help obese people lose as much as 15% of their body weight and keep it off.
- The CDC estimates the annual medical cost of obesity in the U.S. was $173 billion in 2019, and that medical costs for adults with obesity are $1,861 higher than those adults at a healthy weight.
Yes, but: With such an expansive potential market and such a high per-person cost — Wegovy has a list price of about $1,350 a package — the potential costs that could ripple through the health care system are also staggering. - For plan sponsors, "it could be very hard to absorb that new cost," Jeff Levin-Scherz, a managing director for insurance service company WTW told Axios.
Go deeper. |
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| 2. The next COVID boosters |
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| Illustration: Sarah Grillo/Axios |
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| FDA advisers have set a meeting to decide how to make the next round of COVID-19 boosters available to the general public this fall, now that they're available for older adults and high-risk people, Axios' Oriana González writes. Driving the news: An FDA expert panel will meet June 15 to discuss and make recommendations on what strains to include in the "periodic updated" COVID vaccines this fall. - The FDA has said that it intends to make decisions about future vaccination after the panel meeting.
The big picture: U.S. health officials have previously indicated that they plan to recommend that people get COVID shots once a year, a similar schedule to the flu vaccine, as COVID becomes more normalized. What they're saying: "At some point, the virus is divergent enough from the strain for which the vaccine was designed that you need to consider a modified design," Sten Vermund, professor of public health and pediatrics at Yale School of Public Health, told the Wall Street Journal. Of note: Novavax's COVID protein-based vaccine is the only monovalent vaccine available in the U.S. The two-dose vaccine is authorized for people aged 12 and older as a primary series and as a third dose for adults 18 and up. |
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| 3. DEA temporarily extends COVID telehealth rules |
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| Illustration: Gabriella Turrisi/Axios |
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| The DEA has asked the White House for more time to finalize draft rules that proposed reinstating stricter limits requiring doctors to evaluate patients in-person before prescribing certain drugs — like Adderall and opioid use disorder treatment — via telehealth, Axios' Sabrina Moreno writes. Driving the news: DEA administrator Anne Milgram said on Wednesday that temporarily keeping the pandemic-era flexibilities as is would allow Americans to access needed medications "while we work to find a way forward to give Americans that access with appropriate safeguards." - It's unclear how long the extension will last.
The big picture: The DEA still has to make a final decision on the future of the policy. Draft rules, proposed by the agency in late February, led to more than 35,000 public comments and major backlash among patients and behavioral health experts who said the proposals would disrupt care and access to treatment. - Under the proposed rules, a patient would be unable to receive some controlled substances via telehealth after a six-month grace period if that patient had never been seen in person.
Read the rest. |
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| A message from PhRMA |
| Middlemen say they want lower prices |
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| Yet they often deny or limit coverage of lower-cost generics and biosimilars while giving preferential coverage to medicines with higher prices. This might be good for PBMs' bottom line, but it can lead to higher costs for patients. It's time to break the link between PBM fees and medicine prices. |
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| 4. FDA approves first-ever RSV vaccine |
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| Illustration: Annelise Capossela/Axios |
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| Vaccines against the respiratory syncytial virus are expected to be available for the first time before RSV season for older adults after the FDA on Wednesday approved GlaxoSmithKline's vaccine, Oriana writes. Why it matters: GSK's vaccine is approved for adults aged 60 and older, a population that is particularly vulnerable to RSV. The disease causes up to 10,000 deaths and as many as 160,000 hospitalizations for people 65 and up per year, per the CDC. The big picture: The FDA is also expected to make a decision later this month regarding Pfizer's RSV vaccine, a candidate for the same age group. By the numbers: Trial data showed the GSK's vaccine was 94% effective at lowering the risk of severe illness and approximately 83% effective at reducing symptomatic infection in adults aged 60 and older. What else is happening: Children younger than 5 years old are also vulnerable to RSV. However, the FDA is not currently considering a vaccine candidate for kids and infants. Share this story. |
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| 5. Catch up quick |
| 🧃 Michelle Obama starts food-and-drinks company aimed at fighting childhood obesity. (Wall Street Journal) 🫀 Oft-prescribed beta-blockers may not be wise for many heart patients. (STAT) 🍎 Schools ended universal free lunch. Now meal debt is soaring. (NPR) 👻 Senate Finance looks at "ghost networks." (Axios) |
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| A message from PhRMA |
| PBMs control your health care |
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| They decide if medicines get covered and what you pay. They often deny or limit coverage of lower-cost generics and biosimilars, instead covering medicines with higher prices. This business model allows PBM profits to soar and can lead to higher costs for everyone. What else are they hiding? |
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| Thanks for reading, and thanks to Alison Snyder, David Nather, Laurin-Whitney Gottbrath and senior copy editor Bryan McBournie for the edits. |
 | | Dive deeper into the future of health care | | |
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