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Did you know GLP1 meds could bankrupt healthcare? The shocking truth about why some patients can't get coverage! The financial strain of GLP1 medications is forcing difficult decisions in healthcare. Julie Schulz and Mike Dovidio discuss how the expanding indications could qualify over half the US population, creating unsustainable costs for insurers. Discover how Avalon Healthcare Systems is using data to create more personalized, equitable healthcare solutions while managing costs. Learn about the challenges of GLP1 medications and how innovative approaches to patient selection can improve outcomes while reducing administrative burdens. Don't forget to like, subscribe, and hit the notification bell to stay updated on more inspiring stories of innovation and resilience! ____ 1 The Universal Challenge: Saving Money in a Strapped Economy (m.j) [00:00:00] nathan-c-_2_01-17-2025_092011: What are the kinds of questions that they're bringing to you? how do these conversations, these partnerships get started? [00:00:06] Mike Dovidio: Typically it starts with how can you save us money? Everybody's strapped right now. You see it across basically every industry. but when we think about specifically like GLP1s, we're already seeing that the sort of pot of dollars that a health insurer has to work with is not enough to cover all of the patients that A, are eligible for the drug based on the FDA approval, but b, want the drug. You know, there's a lot more patients out there that want the drug that may not have diabetes. you know, even I would go as far as, say, aren't, obese by definition of what your BMI is. And so we are already starting to see some of these health plans quite literally have to lay off their workforce because they've just gone above and beyond what their budget is for their pharmacy spend. and specifically [00:01:00] noting that GLP1s are a big source of, you know, what's sort of. pulling those dollars away [00:01:11] nathan-c-_2_01-17-2025_092011: So if I heard correctly. In the industry, the cost of supporting GLP1's for even just the folks who deserve it or who qualify for it medically, and if you include the rest of the folks who want it, is straining that care budget to the point where insurers have to lay people off in order to fulfill those insurance obligations. [00:01:40] julie-schulz_1_01-17-2025_092011: Exactly. And I would add if it's okay, you know, patients are suffering as a result of this too, because if you look at, North Carolina, for example, they initially offered coverage for, weight loss for GLP1's, but spent a hundred million dollars on it, went completely over budget, and now we're in a situation where they can't cover it at all. and [00:02:00] so we really need to help find that. sort of happy medium of, where we can provide coverage to the patients who need it most in a cost effective manner. but unfortunately, if we let everyone who qualifies for GLP1's, which, given the expanding set of indications, could be more than half of the US population, we would completely, bust the budget of our health care programs. 00:00 1 - The Universal Challenge: Saving Money in a Strapped Economy
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