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The impact of GLP-1s: American Diabetes Association and Teladoc Health on what plan sponsors should consider

For people with cardiometabolic diseases like type 2 diabetes or obesity, 5% weight loss can go a long way. It can help improve health outcomes due to lowering the risk of further complications and reduce related medical costs. Weight loss can be complex and challenging, but GLP-1 anti-obesity medications have been proven to support people in achieving 15% weight loss.

The promise of anti-obesity drugs, along with the high cost of a prescription, has plan sponsors evaluating how they cover them. Whether plan sponsors already cover GLP-1 medications for weight loss or are considering it, more than half of one section of plan sponsors have plans to offer virtual care programs for anti-obesity drugs by 2026 to help manage their usage.

Dr. Robert Gabbay, Chief Scientific and Medical Officer for the American Diabetes Association (ADA), and Dr. Tejaswi Kompala, Chief Strategy Director for Cardiometabolic Conditions at Teladoc Health, recently shared their clinical perspectives on GLP-1 medications and their impact on cardiometabolic health conditions. They offer key insights on what groups should consider when considering GLP-1 coverage and an overall chronic care program.

Chronic conditions are interconnected

When it comes to supporting people with diabetes or other cardiometabolic health concerns, weight management is a big factor.

“Weight management makes almost everything else better—blood pressure, cholesterol, blood glucose, risk of complications, cardiovascular disease. It's really elevated the treatment of obesity.”

Dr. Robert Gabbay

Chief Scientific and Medical Officer for the American Diabetes Association

For people living with type 2 diabetes, this understanding has helped shift treatment from a singular focus, lowering a person’s blood glucose level, to broader cardiometabolic health goals. “Weight management is of equal importance,” Dr. Kompala said.

Because of interconnectedness, obesity needs to be considered a disease, she said.

“Once you start thinking of obesity as a disease, you start treating it more effectively,” Dr. Gabbay said.

What makes a good diabetes management program

According to Dr. Kompala, a practicing endocrinologist, a good program starts with personalized, realistic goals. For some people with diabetes, that goal is remission.

Terminology matters, Dr. Gabbay said, which is why the ADA uses “remission” and not “reversal” to describe goals for people with type 2 diabetes.

“People can go into remission, meaning they have normal glucose levels, but they are still at risk for developing complications and need to be screened for those on a yearly basis,” Dr. Gabbay said. “If someone says, ‘I’ve reversed diabetes.’ Then they don’t need to think about it anymore. And that’s not true.”

Besides appropriate goals, a good program offers holistic support that considers a person’s mental health. The rate of depression in people with diabetes is higher than those without the condition.

This makes people less likely to do the things that will help them live healthier with diabetes, Gabbay said. “It’s important to recognize the mental health side, identify it and treat it.”

Dr. Kompala said that of her own patients, there are so many differences, and each person requires a plan tailored to their needs and preferences. To help deliver on its goal of better health for all people, Teladoc Health diabetes management solutions account for a person’s unique circumstances to make a sustainable impact. This is especially important when it comes to diet.

“The best diet is one that you can stick to,” Dr. Kompala said.

Dr. Gabbay said diabetes care is a marathon, not a sprint. “You can get people to make dramatic changes in their diet,” he said. “But it’s very rare that people will sustain that for the rest of their lives.”

The impact of GLP-1 medications

Dr. Gabbay called GLP-1 medications one of the biggest recent breakthroughs in the management of diabetes.

“If you had to design something for people with type 2 diabetes,” he said. “You’d want it to be effective on weight and lower the risk of complications. These drugs do that very potently.”

“The research is still evolving,” Dr. Gabbay said regarding the use of this class of drugs for weight loss. “GLP-1s have a very clear role in significant weight loss, and we’re expecting to see more risk reduction data coming through.”

“We’ll be in the GLP-1 and associated medication era for quite some time," Dr. Kompala said. And with that means the need to ensure clinically appropriate prescribing of GLP-1s and wrap-around support to maximize the effectiveness of the medication, she said.

“Diet, activity, sleep and stress management continue to be important,” Dr. Kompala said.

“Following the right lifestyle is important for people, even when they’re on these medications,” Dr. Gabbay said.