Lilly Is Winning the GLP-1 Pill Race. But Can It Keep Patients on the Drug?

Dave Ricks, Eli Lilly’s CEO, can share a stat Wall Street will enjoy hearing. Around a third of patients initiating oral GLP-1s are choosing Lilly’s product, Foundayo. According to CNBC, Ricks has stated that they are growing their market share week over week with the oral GLP-1. That is pretty good, considering they’re entering a market Novo Nordisk got a head start on. Market share may not be the stat we should care about.

There is an issue with adherence to GLP-1s

Many studies have shown that these GLP-1s work well. However, that doesn’t mean people will keep taking them after the first few months. After reviewing many studies on patients staying on GLP-1s or Tirzepatide, it was found that they tend not to adhere to the treatment plan. Patients stopped because of GI side effects. Other factors included the cost of other medications, ineffectiveness, and rare side effects patients may have worried about. (Source)

This is key to understand because we hear about how many people have been prescribed the drug or how many have started. If we want people to stay on the medication long term, we need to look at how many people stay on it.

Not how many are starting. We know from studies on Lilly’s oral GLP-1 that some patients will experience side effects. At 5.5 mg,6% stopped

At 5.5 mg, 6% stopped due to side effects. At 9 mg, 9% of patients stopped due to side effects, and 10% at 17.2mg. Placebo showed only a 3% rate. GI side effects were what caused most patients to stop the medication.

We do know that there is an issue with patients continuing to stay on the drug long term.

If they stop taking GLP-1s, they will regain weight and see their cardiometabolic risk factors rise. That means companies will need people to stay on the drug to make money off these patients.

Who is going to pay for these drugs?

That’s another question we need to ask. How are companies going to provide these drugs to their massive number of employees who may want to take them?

In a study done by the International Foundation of Employee Benefit Plans. Only 36% of corporations offered coverage for GLP-1’s for both diabetes and weight loss. 60% of employers offered coverage for just diabetes. Of the employers that didn’t cover weight-loss GLP-1s1s 83% carved them out of their medical or pharmacy benefits.

This issue isn’t going away anytime soon either. Around 10% of employers that offer GLP-1 coverage for weight loss will remove it in 2027. According to Reuters. Mercer also found that 5% of large employers will remove coverage.

As more patients take GLP-1s, prices will rise. Even if the price per patient goes down, it will still cost the company more overall to cover that many patients. Companies want these drugs to succeed and be adopted by more people. But if more people adopt it the costs to companies will rise, which will make them less likely to offer it to their employees.

Foundayo helps, but not by much.

Having a pill you can take without having to eat anything or even drink water. Lilly sold their product for $149 per month if you wanted to self-pay. Those covered by insurance could pay as low as $25. This is helpful, but we still have the question of how long patients will stay on the medication. Will they be able to tolerate it? And who will pay for patients to continue taking it?.

Those questions will help us predict how big this market will get.

Wall Street needs to start looking at how many patients stay on the medication

How many are staying on it at 6 months?

How many are staying on it after a year?

How many stopped due to side effects?

How many stopped because their insurance decided to stop paying for it?

How many came back onto the medication?

How much weight did they gain after stopping the medication?

Those are the stats we need to know about if we want these companies to succeed in selling GLP-1’s to the masses. I think Lilly has done an amazing job getting a third of the patients to start their drug. They have shown they can compete with Novo and take market share.

But how many patients will stay on the drug? Who will pay for them to stay on it?

Those are the questions that need to be answered to know how successful these drugs will be. People need to stay on the medication to see these drugs succeed.