Getting AOMs on Drug Formularies

Last week I chaired and moderated a workshop for formulary managers (mostly pharmacists and pharmacoeconomists) in Ryadh. The goal was to discuss what it would take to get anti-obesity medications (AOMs) onto formularies at their respective institutions. 

For one, I was pleasantly surprised by the enthusiasm and sophistication of the discussion. 

There was no doubt that obesity was recognised as a major health problem (about 60% of the Saudi population is living with overweight or obesity) and that medication was going to be part of the solution. 

As far as I could discern from the discussion, the following considerations are important in any discussion around adding these (or any) medications to the formularies:

  1. Efficacy and health outcomes
  2. Safety and tolerability
  3. Cost effectiveness
  4. Availability of alternatives
  5. Availability and security of long-term supply chains
  6. Ease of administration
  7. Adherence and real-world effectiveness
  8. Ability to monitor, regulate, and assess usage
  9. Availability of HCP capacity and expertise to ensure appropriate use
  10. Overall budget impact

Obviously, for any medication, this would be a high bar to meet. While the new generation of nutrient-stimulated hormone (NuSH)-based medications may be highly efficacious and safe and patient need may be significant, demonstrating real-world effectiveness, security of supply, ability to monitor, regulate, assess usage, dearth of qualified HCPs, and the substantial budget impact remain significant challenges, particularly for anti-obesity medications. 

Nevertheless, there was considerable optimism that most of these challenges will eventually be met and that in time, there is a good chance that anti-obesity medications will become part of formularies similar to medications for other chronic diseases. 

Berlin, D

Disclaimer: I have received honoraria as an independent medical, research and/or educational consultant from various companies including Aidhere, Allurion, Boehringer Ingelheim, Currax, Eli-Lilly, Johnson & Johnson, Medscape, MDBriefcase, Novo Nordisk, Oviva and Xenobiosciences.