The Science and Supply Behind GLP-1s
3-Part Series
Part 3 of our "The Science and Supply of GLP-1s" series: Chronis Manolis, Chief Pharmacy Officer of UPMC Health Plan, brings the insurance company perspective on navigating the GLP-1 paradox: "we've never had drugs this innovative", and yet the whole industry has a mentality of locking things down with respect to access to them!
Some of what we discussed:
[3:00] we've never prior auth'ed diabetes drugs, "we will bring the system to its knees" if we do so
[6:45] predicting the evolution of pricing, competition
[10:55] "we wouldn't dream of coveraging the anti obesity drugs without a medical wraparound program"; are these lifelong therapies? do we need ongoing reauthorization?
[12:30] what we can learn from Sovaldi (hep C)
[13:45] cost effectiveness of GLP-1s for diabetes vs obesity
[18:25] recent Medicare coverage decisions
[19:50] the provider perspective; high discontinue rates as a big challenge (and our inability to know WHY because of lack of data)
[22:30] health plan build vs buy decisions on wrapper programs, centers of excellence
[25:27] formulary design; "I've never seen pharmacy as complex as it is today."
[28:00] novel pricing mechanisms, the need for pharma and payor collaboration
[30:20] Chronis Manolis has the best name in healthcare
Listen to the full episode here: https://a16z.com/podcast/the-science-and-supply-of-glp-1s-with-chronis-manolis/
And this was a perfect adjunct to the prior episodes with our other amazing expert guests:
Part 2: Brooke Boyarsky Pratt of Knownwell
https://a16z.com/podcast/the-science-and-supply-of-glp-1s-with-brooke-boyarsky-pratt/
Part 1: Dr. Carolyn Jasik of Omada
https://a16z.com/podcast/the-science-and-supply-of-glp-1s-with-carolyn-jasik/
