Mapping out the emerging ecosystem built around the massive demand for GLP-1 weight loss drugs, such as Wegovy / Ozempic & Mounjaro

Some thoughts on how this space evolves:

• As demand for these drugs has exploded, many digital health & legacy weight management companies (i.e. WeightWatchers (WW)) have launched monthly subscription products offering GLP-1 prescription access, insurance approval assistance and "holistic care management
• Companies like Noom (~$120 / month), Ro (~$135 / month) and Calibrate (~$138 / month) connect consumers with clinicians to streamline the prescription & insurance process

Prescriptions cost extra (sometimes >$1000 OOP), but the services will fight your insurance for you

• While we await the full data, Novo's successful CV outcomes study (SELECT) should put pressure on payors to increase drug reimbursement rates, but given the cost & perpetual usage, we'll likely still see utilization management programs that limit access
• These could include:

(1) Step-therapy access (try alternative treatment first)

(2) Physician attestation requirements

(3) Holistic care plan, including weight loss coaching

All of the players below are angling to capitalize on these likely requirements

• It's worth calling out that a lot of companies offer alternatives to medications, essentially zeroing in on the "step therapy" access restriction by serving as a 1st line of therapy. These include behavioral change, counseling & at-home diagnostic testing kits / apps and are important alternatives given ongoing supply & insurance reimbursement issues with current drugs will disproportionately impact those of a lower socioeconomic status (i.e. push them towards potentially dangerous compounding pharmacies)
• GLP-1s have so radically shifted the weight loss market, that even legacy players like WW (which notably eschewed Rx solutions) has pivoted with its acquisition of Sequence earlier this year
• It marks a significant pivot in the social nature of weight loss programs as well. Historically, programs like WW or Jenny Craig were a place for people to share the day-to-day of their journeys, but that's almost entirely been replaced by TikTok & others (i.e. #ozempicjourney)
• The obvious concern is that with so many undifferentiated offerings launching at once, the incentive will be to make up the lost pricing power with more volume

Essentially turning into "prescription factories with perks

• For now, most brands have purported to maintain strict BMI criteria and safety signals for the GLP-1 class are much better than SSRIs or pain meds. For many, losing weight is a good thing.

Still, these are drugs you seemingly need to be on for life - it's worth being cautious