GLP-1 Support from Solera can save tens of millions by streamlining step therapy and the prior authorization process for health plans while providing education and alternatives for members
PHOENIX, Sept. 05, 2023 (GLOBE NEWSWIRE) -- Solera Health, the premier technology platform for connecting people seamlessly and easily to health solutions that work, today announced the launch of Solera GLP-1 Step Therapy Support – a first-of-its-kind solution to combine evidence-based weight management programs with operational support for health plans implementing step therapy and prior authorization for GLP-1s. In addition to offering desirable solutions for weight loss prior to a patient receiving a prescription for a GLP-1 drug, the solution includes an educational campaign emphasizing key clinical and scientific points about GLP-1s that help members make a personalized choice – often preferring to forego a potentially lifelong, injectable medication.
The GLP-1 Landscape: Challenges with Costs and Patient Education
As GLP-1 drugs like Wegovy and Ozempic sweep the headlines and take over social media, consumer demand is exploding for GLP-1s for weight loss. Five million GLP-1 prescriptions were written in 2022, a 2,082% increase from 2019, with the market forecasted to grow to $100-200 billion within the decade.
To capitalize on this market, numerous startups and weight loss companies offering teleprescription services for GLP-1s have emerged. However, increased access to these medications – often with limited clinical oversight and shared decision making – is creating new and serious economic pressures for payers, potentially crowding out other clinical and non-clinical services. GLP-1 prescriptions can cost $12,000 or more annually, and widespread adoption at current pricing would be an untenable financial burden on society.
Moreover, new data from the Kaiser Family Foundation suggests that many patients are turning to GLP-1s without understanding important facts about their long-term effectiveness. For example, recent data demonstrated that although 45% of Americans are initially interested in taking a GLP-1 to lose weight, that portion decreases by almost 70% when individuals learn they will regain their weight should they stop the medications.
It is becoming clear that there is an acute need to present individuals with the full suite of options for weight loss, educate them on the benefits and potential drawbacks of GLP-1s, and track progress to ensure the best possible patient outcomes. A step-therapy approach utilizing lifestyle change and an Obesity Center of Excellence model for counseling and prescribing stands to generate tremendous financial impact. Solera expects to divert 30 to 60 percent of those patients into another effective weight management option following step therapy. For every ten thousand eligible individuals pursuing GLP-1 therapy, that diversion yields an annual savings between $40 million and $72 million.
Solera helps plans manage GLP-1 demand support member health through an improved step therapy process
Solera GLP-1 Step Therapy Support helps to address the high costs of GLP-1 drugs by enabling effective step therapy and delivering more efficient, automated operational workflows. In addition to offering members immediate access to lifestyle change programs, Solera’s solution allows payers to gain visibility into member participation and progress in their weight loss program, providing key information needed to improve internal workflows and eliminating the manual, case-by-case authorizations which create bottlenecks for plans and erodes the experience for members. The solution is crucial for members as well, as it provides education to help patients better understand GLP-1s, and offers alternative weight loss options when they are a better fit for that individual.
“GLP-1s represent an incredible advance for weight loss, but too many patients are being convinced that these medications are their first or best option,” said Dr. Byron Crowe, Chief Medical Officer at Solera. “When offered better education and seamless access to effective lifestyle change programs, many individuals choose to lose weight without a medication. And for those who do choose to pursue a medicine, we improve the entire experience for both the member and the health plan through better operations.”
Solera GLP-1 Step Therapy Support capabilities and benefits
GLP-1 Support at Solera is comprised of two complementary solutions: prior authorization support, and consumer education.
Step Therapy and Prior Authorization Enablement is a turnkey solution to help health plans automate GLP-1 prior authorization, providing the lifestyle variables and interventions needed to confirm the member’s readiness for a GLP-1 drug, which offers:
- Immediate access to evidence-based lifestyle interventions covered under the medical loss ratio (MLR) that support the member prior to and, if needed, during medication therapy
- An integrated reporting suite that seamlessly provides the lifestyle and weight loss information needed for prior authorization
- Configurable prior authorization variables including, length in program, percentage of weight loss and activities in program
Consumer education is an easy-to-implement, all-in-one solution that educates consumers on alternatives to GLP-1s through lifestyle and clinical education content, which offers:
- An automated consumer education email campaign to explain how GLP-1s work and possible alternatives
- Intermittent survey questions to assess how attitudes toward GLP-1s have shifted after the education campaign and during engagement with a lifestyle program
- End of program survey to measure likelihood individual still will pursue a GLP-1
Solera is leveraging it’s ability to transform lifestyle behavior change variables into clinical event codes to power obesity step therapy workflows. Solera’s Obesity Center of Excellence will help to enable prior auth workflows and diversion through education of GLP-1s. It will combine Solera’s lifestyle weight management programs, teleprescription capabilities and additional support to manage the individual comprehensively.
“Individuals need a complete suite of options for effective approaches to weight loss - ensuring the best possible outcomes,” said Mary Langowski, CEO at Solera. “Unlike other programs that simply seek to divert, Solera is pleased to offer a unique program that provides consumers with multiple options to address their weight management needs, while preventing overprescribing.”
Solera GLP-1 Step Therapy Support is available to payers and employers now and can be live in less than 60 days. To learn more, visit soleranetwork.com.
About Solera Health
Solera is changing lives by guiding people to better health solutions that work. Solera’s value-based technology platform enables successful interventions that address the most prevalent and costly chronic conditions. Solera matches consumers to their best-fit solution within carefully curated networks of digital and community-based point solutions, and drives superior engagement and outcomes by managing performance. Solera’s technology platform serves payers and employers by streamlining, integrating, and creating accountability in the point solution ecosystem. For more information, visit www.soleranetwork.com.
Contact:
BOCA Communications for Solera
solera@bocacommunications.com
