Getting AOMs on Drug FormulariesTuesday, October 24, 2023
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:
- Efficacy and health outcomes
- Safety and tolerability
- Cost effectiveness
- Availability of alternatives
- Availability and security of long-term supply chains
- Ease of administration
- Adherence and real-world effectiveness
- Ability to monitor, regulate, and assess usage
- Availability of HCP capacity and expertise to ensure appropriate use
- 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.
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.