Hi, everyone. This is Erica Spicer Mason with
Becker's Healthcare. Thank you so much for tuning
into the Becker's Healthcare podcast series.
So today we're going to talk about managing
GLP-one costs and patient outcomes.
And joining me for this conversation is Jennifer
Jones, the director of clinical solutions at Noom
Health. Jennifer, welcome. Thank you so much for
being with us on-site at the annual meeting
today. Absolutely. Happy to be here. So before
we get into our conversation, and I'm really
excited about this one. GLP ones are so
top of mind for many. Mhmm. But before
we do that, would you like to share
just a little bit more about yourself, your
background, your work in healthcare? Yeah, absolutely. So
I actually started as a registered dietitian.
When I graduated
and completed my internship, I actually worked in
a couple different healthcare settings and quickly realized
that was not the place for
me. While I loved patient care, I did
not love kind of I hate to call
it like the stiffness of clinical work, but
wanted to do just just more with that,
have a bigger impact truly. So I kind
of bounced around doing some different,
employer health and,
data analytics
before coming into Noom, which really has found,
I'd say, like the sweet spot for me,
weight management and overweight treatment has always been
a passion of mine.
So at Noom, it's been really helpful to
see kind of the the biology and the
medication and the the weight management components all
come together
as we think about helping people lose sustainable
weight and then overlaying that with medications,
when applicable as well. Yeah. Oh, well, it's
great to learn more about you, Jennifer. Thank
you for sharing that. And it sounds like
at Noom, to your point, you're really at
the intersection of so many issues that are
happening in health care right now when it
comes to weight management,
the costs associated with it, and health outcomes.
So
excited to get into that. And I wanted
to also just start broadly by acknowledging something
many of our listeners probably are well aware
of, which is that GLP one consumer demand
and the costs are soaring. Mhmm. So as
this treatment gains traction, what are the unique
challenges and opportunities that payers are facing right
now? Could you just give us, like, a
high level view of where we're at? Yeah.
I think the biggest challenge is a lot
of payers just still don't know what to
do about it. Should they cover it or
should they not cover it? If they cover
it, should we have specific limitations on who
can have access to that? Should it just
be certain diagnoses?
And then it becomes how long should we
cover the medication as well? So
it's always from this frame of mind of
thinking about utilization
and then paying for this and the cost
associated with it.
And what I think we really need to
turn into and focus on is also kind
of that individual that is on the medication
and thinking about this overall experience for the
member
and how we can best
align them with the best protocols, the best
medication, but also behavior change to make it
a more impactful type of
prescription for them, essentially. So
from a payer perspective, again, I think there's
just so much unknown because we continue to
utilize the medications, which can be incredibly impactful.
But we've all we have done is see
the cost rise as far as overall healthcare
costs. So
we need to be able to find a
solution that can intersect the two so we
can see outcomes
that will effectively reduce healthcare costs. And that's
kind of that missing piece that,
payers and providers, I think, are really struggling
with right now. Yeah. Absolutely. And,
you know, you touched on this idea of
payers
kind of having to decide if it's something
they wanna cover, if they do, for how
long. So really touching on that tension of
sustainability
and also access.
Any other
thoughts that come to mind on strategies that
payers should really consider to to strike that
balance right now?
We have always focused on behavior change and,
like, the psychology meeting. That's what Noom was
founded upon, and that's where we have found
our success in particular in the consumer market
even before GLP ones really became a hot
topic.
So where we find success and, again, where
we really push the market to understand is
an individual on these medications
will have success.
Sure.
But will it be long term success? If
they come off the medication, are they gonna
be able to maintain that weight loss? So
we need to be able to find, again,
that missing factor, which in our eyes is
that behavior change. So
if you can get someone to be able
to think about the way they eat differently
and be able to know the importance of
these lifestyle factors that they're choosing
and how that can not only help you
lose more weight with medication,
but ensure that maybe you can come off
of the medication and then ensure that you
can maintain that weight loss after the medication.
That's really that sweet spot that I think
we're missing right now in the market is
how can we also apply lifestyle to the
effects
medications? Yeah. That that's such a helpful perspective.
And
just to share something personal quickly, I'm a
former health educator. So what you're saying is
completely speaking to what I know to be
true, which is behavior change is probably one
of probably one of the most difficult things
Absolutely. To pull off, but it's so important
for something like this to see sustainability.
So keeping that in mind, what are some
specific examples of,
you know,
support or other approaches that payers can take
in order to really achieve that? I know
you mentioned education as a piece of it.
Any other examples come to mind? I think
the support is a a key piece too.
I think oftentimes,
we treat obesity just as
obesity, and there's certainly much more recognition that
it is a chronic condition now. And with
a chronic condition, there needs to be that
holistic support.
So you have the medication,
we have the behavior change. Now a missing
piece there is that community
type of support, the mental health type of
support that goes along with treating any other
chronic condition.
So understanding that people need connections and they
need to be able to have someone that
they can go to for support
when they're hitting their highs, when they're hitting
their lows, when they they have questions,
as well as other individuals that are going
through the same types of struggles and the
same type of path with them as well.
So being able to, from a payer perspective,
have those types of communities,
and connections that you can connect individuals with
that are going through the journey. I think
that oftentimes, again, is another piece that
and as we think about the treatment of
obesity and overweight as a whole is a
piece that's sometimes forgotten about as well. So
that's another, strategy that can be employed too.
Yeah. It's fascinating. And it brings to mind
how I'm noticing a trend there, you know,
beyond weight loss, but even fitness apps, I
know they used to be strictly
workout based. And here's your workout for the
day or the week. But now there are
these community elements. I've noticed so many providers
adding on, and I it sounds like there's
certainly something behind that Yeah. Having a support
system. Yeah. And it's, you know, it's not
the right thing for every individual, but it's,
you know, some people really wanna keep their
anonymity.
Mhmm. But others really do wanna be able
to share those successes or, you know, you
find someone that, like I was just talking
with a coworker at our booth. We were
comparing,
on our Oura ring stats, like our, cardiovascular
age. And she's like, I'm at 6.5. I
really wanna be at nine. And I'm like,
oh, well, I'm at nine. She's like, well,
now I'm chasing you. So it's like this,
you know, fun competitiveness of like, oh, I
I see it's attainable. So I wanna I
want to be like that, And I wanna
learn from them as far as how they
got there, and just develop those connections with
people. Yeah. Fascinating. Oh, I feel like I
could talk about this with you all day.
I know we have limited time, so I
do wanna make sure we kind of touch
on where GLP ones are headed and the
future landscape for those. We know that the
usage of this treatment is expanding past diabetes
and weight loss into other therapeutic areas too.
So
from your view, what do you think payers
should really be anticipating right now with cost
coverage and also innovation?
Is there one action they could take now
to better prepare? Yeah. There's definitely
many more,
conditions that are now, you know, covered to
use GLP-one medications, like obstructive sleep apnea, fatty
liver disease.
I think I think the challenge is now
you continue to open the door for these
other diagnoses to use these medications, which will
absolutely help.
But, again, we're still not addressing the main
problem of we're just giving someone a medication,
and we're not supporting the components that need
to come with that medication.
You wouldn't just hand insulin off to a
diabetic without teaching them how to use insulin,
the proper nutrition that goes with that, what
to do if you have side effects. It's
the same way with GLP-one medications. Mhmm. Maybe
not necessarily as severe in some cases, but
you have to be able to frame it
with, there needs to be some very thorough
education and prescription that goes along with that
medication to be able to make that successful.
Yeah. And I think when we look at
the pipeline coming down the line, we know
that there's some oral medications that are in,
like, phase three testing that will probably come
to market late this year, early next year.
I think our biggest hope, honestly, with those
is that will help reduce the price, which
can reduce access to the medications as well,
which then allows us to
utilize these medications for individuals that maybe aren't
on a health plan that covers them. Maybe,
you know, from a health equity standpoint, can
we start to utilize these medications in underserved
populations
that don't have the opportunity today because of
the cost and it's so prohibitive?
So there's there's a lot. And, you know,
they're going to continue to have
more,
pharmaceuticals that will come to market, and they'll
probably continue to be more conditions that will
be covered by the medications.
That one, though, one other point I think
to make on that that's interesting, because this
came up in our session as far as
when when you think about some of the
other conditions that will be covered for GLP
ones,
they can be affected if someone loses weight.
So if you lose weight,
does your sleep apnea improve? If you lose
weight, does your fatty liver improve? You know,
like, so all of these additional conditions that
are so intertwined with obesity.
So if we can solve for one, can
we solve for all?
And is it worth putting a lot of
resource into solving the obesity issue
before trying to solve everything else that can
cascade from that?
Fascinating. It's it's complex when you think about,
to your point, this cascade effect that we
can envision with, you know, as these GLP
ones are in the market as time goes
on and coverage expands. Mhmm. But what I'm
hearing in your response, Jennifer, is that the
best thing for organizations to do right now
is to be thinking about the future, not
just to be living in this here and
now. Can we give GLP ones? What's it
going to cost? It's more than that. It's
Yeah. Building a plan and intention behind the
intervention. Yeah. And and, you know, right now,
it's GLP ones. And who's to say that
there's not some other new peptide that comes
to market in the next three years that's
even more expensive or, you know, has different
pathways as far as within the body? So
to your point, yes. Developing a strategy that
will take you three to five years ahead
of time to be able to know what's
coming to market and address
future medications and in future treatments as well.
Yeah. We've definitely been kind of playing,
reactive,
with a lot of this as far as,
oh, it's on the market now. How are
we gonna cover it? What are we gonna
do? And it's like, well, we should have
thought about this, you know, three to five
years ago before the before the Wegovis and
the Zebbounds came to market. Yeah. Innovation, the
piece of it's moving quickly and we have
to keep up. Yeah. But, Jennifer, I so
appreciate all the insights you've given us today
in the short amount of time together.
Anything that we didn't hit on that you
think would be helpful for our audience to
know before we close?
I think just some statistics, I think, just
to keep in mind. I shared these earlier
because I think it is just fascinating. When
we think about GLP-one medications, the first one
actually came to market in 02/2005.
So it's a lot different as far as
with the effectiveness and and side effects and
outcomes that we see with the ones that
are in market now. But we've had the
opportunity to really capitalize on these medications and
hopefully bend the curve from an obesity standpoint,
and we haven't.
So, you know, our obesity rate is still
above forty two percent. We combine that with
overweight, it's above seventy percent. That's projected, you
know, obesity rates are projected to be above
fifty percent in the next five years or
so.
We had,
ten years ago, 41 states that had an
obesity rate below thirty percent.
Today, it's eight. So in ten years,
we have
achieved this
huge amount of people that have now become
obese.
And when we think about, like, we've had
these great medications,
but they're not changing. It's not bending the
curve at all. We have to do something
different in order to truly
get the impact from the medication, but also
get people healthier. Like, we're spending more and
more from a payer perspective, from an employer
perspective, and a member perspective.
We have to be able to think about
this differently to truly have an impact. Yeah.
Oh, you're leaving a lot for our listeners
to think about, Jennifer. I I so appreciated
our conversation today. Thank you so much for
making time for Becker's. Yeah. Thanks so much.
It's a pleasure. Yeah. And we'd also like
to thank Noom for sponsoring today's podcast.
And listeners, be sure to tune into more
podcasts at Becker's Healthcare by visiting the podcast
page at beckershospitalreview.com.