This is Jacob Emerson with Becker payer issues podcast. Here's your bi weekly industry news briefing for May 20 second. Well, a new study from the Blue Cross Blue Shield Association published May 20 first is found that a majority of patient taking weight loss drugs, discontinue use of their medication before reaching a
clinically meaningful health benefit it. That study was conducted by the data arm of the association, Blue Health Intelligence, and it's based on national pharmacy and medical claims data from nearly a hundred and 70000 commercial insurance members, the largest study of its kind to date. Members included in that study were prescribed Go or Sa between July 20 14 and December 20 23, and they had at least 6 months of continuous enrollment before and after they began taking
Gl ones. High Patients taking those drugs should complete at least 12 weeks of continuous treatment and to achieve weight loss that will positively impact their health. Bc sa, Vp of clinical affairs said that when patients take medication, they wanted to be safe and effective. The study shows, most people are unlike to see lasting benefits and that unfortunately, weight loss isn't as simple as filling a prescription.
Now, in that study, it really found that 58 percent of patients discontinued Gl 1 use before reaching a clinically meaningful health benefit. 30 percent of patients continued use of weight loss drugs within the first month of treatment. A majority of Gl 1 prescriptions came from a primary care provider, patients who received a prescription from an endo or obesity medicine specialist or more likely to stick with treatment. Patients who saw their physician more often, regardless
of specialty. We're more likely to continue with treatment. Patients ages 18 to 34 were more likely to drop out of treatment. Sooner.
Gender had no effect on dropout rates in the first 12 weeks and patients with coexist conditions such as peripheral vascular disease or diabetes, Particularly those with 3 or more similar conditions were more likely to continue traits Well, 2 states have recently signed prior authorization reform bills into law In Oklahoma, a bill signed, will require prior authorization procedures to be published on websites available to patients and provider. This bill goes into a effect on January first.
Those with chronic conditions must be notified no less than 60 days prior to changes that will affect them. If a prior authorization is denied, appeals must be reviewed by providers of the same or similar specialties. Payers must respond to urgent requests within 72 hours and within 7 days for non urgent request. And in Vermont, the governor Phil Scott has signed a bill to reform the prior authorization
process in the state. That legislation aligns prior auth with Medicaid and claim edits With Medicare. It also allows patients and providers to ask for exemptions to step therapy, and requires payers to decide prior authorization hospitalizations within 24 hours for urgent situations and 2 business days for
non urgent care. It also directs the state's Department of Financial Regulation to prohibit prior author requirements for certain medications and services and require insurers to collect cost sharing amounts from patients. Bc of Vermont had raised concerns that the legislation would cause insurance rates to rise between
5 and 7 percent. The governor said that to alleviate to pay concerns, he is directing the State's Department of Financial Regulation, and the agency of human services to jointly study the effects of the bill on health outcomes, costs, and insurance rates They are to report back to him on the findings. That study will also include a cost impact analysis of prior authorization laws in other states.
To evaluate whether they have been successful in improving outcomes or reducing health care costs by reducing burdens for providers The governor's also requesting that the Green Mountain care board uses its authority to identify cost savings associated with reduced administrative burdens and to which ensure those savings pass all the way through to state residents in the form of lower costs, that legislation goes into effect in January 20 25.
Well Opt rx has unveiled a new pricing trend on May twentieth, following an industry wide trend of increasing transparency on medication costs. The pharmacy benefits pricing offering called Opt clear trend guarantee combines guarantees into a single per member cost and will offer drug benefit plan sponsors greater predictability of pharmacy spend. It's to help manage total lowest net cost. The company said the new pricing model, which will be available in January 20 25.
Builds upon its cost made clear payment solutions that feature cost plus pricing with lower ingredient cost. Clear trident and guarantee is an alternative that combines resale, home delivery, specialty drug and rebate components into 1 per member value based model. Opt, the third largest Pb with its handling of 22 percent of Us prescription claims in 20 23 is jumping into a popular trend. Following the increasing disruption status of Mark Cuban
cost plus drugs pricing model. The nation's largest Pb are now offering similar services, as consumers demand more transparency and federal investigators probe the industry. And finally, employer adoption of Ic is up 29 percent since 20 23. That's according to a may report from the Hr council.
Or individual coverage health reimbursement arrangements allowing employers to offer a defined tax advantage contribution used to reimburse premiums for an individual health plan purchase by employee on their state's Aca exchange. Now Adoption grew 29 percent year over year between 20 23 and 24. Ic 84 percent among employers with 50 or more employer employees.
Among employers surveyed, 83 percent were not able to offer health benefits until they offered an ic or qualifying small employer Hr. 17 percent of employers switched from traditional group coverage. The number of employees offered to defined contribution health benefits now exceeds 200000 people, and that figure does not include dependence. So some estimates have said that more than 500000 people may Nationwide
enrolled. 25 percent of employees choose silver plans, 34 percent choose bronze and 35 percent choose gold, The top metro areas for Ic adoption in ranking order are New York City, Atlanta, Los Angeles, the San Francisco Bay Area and the twin cities in Minute. Soda. If you like the latest health insurance industry news delivered straight to your inbox every morning, subscribe to the Becker payer issues e newsletter on our website at becker payer dot com. So