Wegovy and other GLP-1s curb demand for bariatric surgery: JAMA study
About 6% of Americans with obesity and without diabetes have had surgery or taken GLP-1 agonists, the research team estimates.
The rise of Wegovy and other new GLP-1 agonist weight-control drugs may be slashing the number of U.S. patients with commercial health insurance or Medicare Advantage plan coverage who undergo weight-control surgery.
The GLP-1 use rate per 1,000 patients with obesity and without diabetes increased to 4.41 in the second half of 2023, from 1.89 in the second half of 2022, according to a report published Friday on the JAMA Network website.
Over that same period, the bariatric surgery rate per 1,000 patients with obesity and without diabetes fell 26% — to 0.16, from 0.22.
Only 6% of patients in the data who were obese but not facing diabetes had taken GLP-1 agonists or undergone bariatric surgery.
Kevin Lin, a health care policy researcher at Harvard Medical School, led the team that wrote the report.
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The JAMA Network website is affiliated with the Journal of the American Medical Association.
The methods: Lin and his colleagues started with data on 17 million patients from UnitedHealth’s OptumLabs Data Warehouse.
All of the patients included in the analysis had commercial health coverage or Medicare Advantage plan coverage, and all had both medical insurance and prescription drug coverage.
The researchers identified 1.6 million patients with obesity and without diabetes.
The researchers then looked for patients who had filled prescriptions for semaglutide or liraglutide, under the brand names Wegovy, Ozempic, Rybelsus, Saxenda, Victoza or Xultophy.
The researchers identified 205 patients had received both a GLP-1 agonist and undergone bariatric surgery during the study period; 5,173 who had undergone bariatric surgery without taking a GLP-1 agonist; and 81,092 who had used insurance to pay for a GLP-1 agonist prescription without undergoing bariatric surgery.
The results show a decline in metabolic bariatric surgery associated with the era of GLP-1 agonist use, the researchers write.
The future: The researchers note that the impact of GLP-1 agonist use on bariatric surgery trends could change as more people take, and stop taking, GLP-1 agonists.
“Although GLP-1 RAs are effective for the treatment of obesity and related comorbid conditions, such as diabetes, the high cost and high rates of gastrointestinal adverse effects can lead to treatment cessation and subsequent weight regain,” the researchers note.
The backdrop: The Lin paper has come out as analysts are starting to try to compare the economic benefits of GLP-1 agonists to the cost of the drugs.
Analysts at Moody’s have suggested that widespread use of the drugs could increase counts for some types of surgery, such as orthopedic surgery, by reducing the number of patients excluded from consideration because of obesity-related safety concerns.
Congressional Budget Office analysts recently predicted that GLP-1 agonist use could add $4,300 in extra care costs per user in 2034 while also leading to an average of $650 in health care cost savings per user.