In this episode of Only Healthcare, hosts Michael Navin and Dr. Randy Vogenberg welcome guest Deborah Williams, a leading healthcare strategy and policy expert, to explore the explosive growth and complex economics of GLP-1 medications like Ozempic and Wegovy.
With her extensive background working on Medicare Part D legislation and with major pharmaceutical companies, Deborah breaks down how these breakthrough diabetes and weight loss drugs exemplify everything wrong with America's healthcare incentive structure.
Key Topics Discussed:
The fundamental problem isn't just drug pricing, it's a system where every stakeholder is incentivized to maximize revenue rather than patient health outcomes, with PBMs controlling access based on rebate potential rather than clinical effectiveness.
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Chapters:
(00:00) Introduction
(02:00) GLP-1 category overview and 442% script growth explosion
(06:00) Patient engagement challenges: lifestyle vs. medication approach
(10:00) Coverage gaps: employer plans dropping obesity coverage
(16:00) PBM rebate demands forcing artificial price inflation
(23:00) Compounding alternatives and FDA policy changes
(27:00) Direct-pay programs: Lilly Direct and Novo Cares analysis
(31:00) Future outlook and policy reform recommendations
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