Jan. 24 Issue of Drug Benefit News Features Interview with Aetna Exec on New Obesity Drug Pilot

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Jan. 24 issue of Atlantic Information Services’s Drug Benefit News features an interview with Aetna’s national medical director for pharmacy policy and strategy on the insurer’s newly launched anti-obesity program.

While many insurers and plan sponsors have been taking a “wait-and-see” approach to two relatively new anti-obesity medications, all eyes may now be on Aetna Inc. as it embarks on a clinically supported pilot to test the benefits of Vivus, Inc.’s Qsymia (phentermine and topiramate extended-release) and Eisai Inc.’s Belviq (lorcaserin HCl). The newly launched program, which is the first partnership of its kind for the drug makers, will evaluate the benefits of either agent “combined with lifestyle support.” For its Jan. 24 issue, Atlantic Information Services, Inc.’s (AIS) Drug Benefit News (DBN) interviewed Edmund Pezalla, M.D., Aetna’s national medical director for pharmacy policy and strategy on the new program’s specifics and anticipated outcomes.

This is the first time Aetna is testing anti-obesity drugs as part of an overall weight-loss management program, which includes the use of CarePass, an application that allows members to “choose from curated applications in the areas of weight tracking, medication compliance, creating and following a physical activity plan and following a diet plan, including access to menus, and other important features,” explains Pezalla. Depending on the plan sponsor, there are other wellness products that may complement the pilot, such as Aetna’s metabolic screening program and Aetna Healthy Lifestyle Coaching programs, he tells DBN.

The insurer will measure potential improvement in overall health outcomes, productivity and medical costs, and expects to have results by the end of 2014. “Then, hopefully we would be able to continue [the pilot] for another year or so to give us a good picture of how patients do on the medications and further assess health and financial benefits to using them,” he adds. In the “medium term,” Aetna may see a decline in the number of members opting for bariatric surgery because they have been successful with weight loss through this program, he says. Compared with surgeries that can cost tens of thousands of dollars, the retail cost of a 30-day supply of Belviq ranges from about $110 to $118 with the use of a coupon, while 30 tablets of Qsymia runs about $167 to $178 with a discount, according to GoodRx.com. And while they can’t be assessed during the pilot, Pezalla says longer term results could include fewer patients developing diabetes or significant hypertension, joint disease and other weight-related conditions.

Visit http://aishealth.com/archive/ndbn012414-01 to read the article in its entirety, including comments from executives at other insurers on their plans for adopting similar models.

About Drug Benefit News
Published biweekly, Drug Benefit News delivers timely news and proven cost management strategies for health plans, PBMs, pharmaceutical companies and employers. Coverage includes up-to-the minute news of industry consolidation, strategies for participation in exchanges, generic promotion tactics, formulary decisions, innovative benefit designs, drug pricing methodologies, PBM contracting, changes in Part D and other federal initiatives, and much more. Visit http://aishealth.com/marketplace/drug-benefit-news for more information.

About Atlantic Information Services
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.

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Atlantic Information Services
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