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Researchers at Cigna's Evernorth Research Institute are seeing early signs that offering patients semaglutide and other GLP-1 agonists might cut the cost of managing mental health problems.
Duy Do and two other Evernorth researchers found that using Ozempic or similar drugs to control blood sugar reduced use of office visits to treat depression by 13% and reduced use of office visits to treat anxiety by 15%.
Use of GLP-1 agonists did not reduce use of emergency room visits or inpatient care for depression or anxiety, but the researchers say their work shows the need for understanding how GLP-1 agonist use affects people's mental health and use of mental health services.
"Given the high economic burden of mental health disorders among patients with T2DM, further research is needed to confirm the clinical and cost-effectiveness of [GLP-1s] in reducing the overall health care burdens for this patient population," Do and colleagues conclude. "
What it means: People with diabetes are more likely to have conditions such as anxiety and depression, and scientists are still trying to understand why.
If GLP-1 agonists really reduce employer plan participants' use of mental health services, that could help hold down the plans' diabetes care costs.
If GLP-1 agonists turn out to help reduce the need for mental health care services for obese, overweight or even normal-weight patients, that could help employers cut overall behavioral care costs.
Related: Drugs like Ozempic cut death risk 30% for people with obesity and type 2 diabetes: JAMA study
There are already early signs that GLP-1 agonists could eventually reduce the cost of treating conditions such as severe kidney disease.
GLP-1 agonists and related drugs now account for about 17% of U.S. employer plan pharmacy claims, according to CBIZ, a Cleveland-based professional services firm with about 4,500 benefit plan clients.
Many employers that do cover the drugs are thinking about pushing them out of the formularies, or covered drug lists, because of cost.
If the drugs start to have a noticeable effect on the cost of treating a wide range of chronic conditions, that could affect the formulary inclusion discussions.
The study: The Do team looked at claim data in the Komodo Healthcare Map claims database for 774,968 U.S. adults who began using Ozempic or other GLP-1 agonists to control their type 2 diabetes between January 2019 and March 2022.
The researchers did not break out GLP-1 impact by enrollee type, but 53% of the claims in the sample were commercial plan claims, and 73% were for adults ages 18 through 64. That suggests that about half of the claims included in the study were paid by employer-sponsored health plans.
When the researchers made the GLP-1 impact comparisons, they were comparing the health care resource use of people with type 2 diabetes who were using GLP-1 agonists with the health care resource use of people with type 2 diabetes who were using Januvia, Oglyza or other dipeptidyl peptidase 4 inhibitors to control their diabetes.
Caveats: The researchers note that their study is just a preliminary look at how GLP-1 agonists affect use of mental health care services.
One concern is that mental health care professional shortages or the out-of-pocket cost of care could be affecting how likely people with type 2 diabetes are to get necessary mental health care, the researchers said.
Another limitation is that the researchers looked only at people with type 2 diabetes, not the impact of use of GLP-1 agonists by people with blood sugar readings in the normal range.
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