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extract: 2025-11-06-trump-novo-lilly-glp1-price-deals-medicare #1077

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domains/health/GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035.md
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@ -37,13 +37,13 @@ MA plans' near-universal prior authorization creates administrative friction tha
### Additional Evidence (extend) ### Additional Evidence (extend)
*Source: [[2025-05-01-nejm-semaglutide-mash-phase3-liver]] | Added: 2026-03-16* *Source: 2025-05-01-nejm-semaglutide-mash-phase3-liver | Added: 2026-03-16*
MASH/NASH is projected to become the leading cause of liver transplantation. GLP-1s now demonstrate efficacy across three major organ systems (cardiovascular, renal, hepatic), which strengthens the multi-indication economic case for chronic use. The 62.9% MASH resolution rate suggests GLP-1s could prevent progression to late-stage liver disease and transplantation, though the Value in Health Medicare study showed only $28M MASH savings—surprisingly small given clinical magnitude, likely because MASH progression to transplant takes decades and falls outside typical budget scoring windows. MASH/NASH is projected to become the leading cause of liver transplantation. GLP-1s now demonstrate efficacy across three major organ systems (cardiovascular, renal, hepatic), which strengthens the multi-indication economic case for chronic use. The 62.9% MASH resolution rate suggests GLP-1s could prevent progression to late-stage liver disease and transplantation, though the Value in Health Medicare study showed only $28M MASH savings—surprisingly small given clinical magnitude, likely because MASH progression to transplant takes decades and falls outside typical budget scoring windows.
### Additional Evidence (extend) ### Additional Evidence (extend)
*Source: [[2025-12-23-cms-balance-model-glp1-obesity-coverage]] | Added: 2026-03-16* *Source: 2025-12-23-cms-balance-model-glp1-obesity-coverage | Added: 2026-03-16*
The BALANCE Model directly addresses the chronic use inflation problem by requiring lifestyle interventions alongside medication. If lifestyle supports can sustain metabolic benefits after medication discontinuation, the model could demonstrate a pathway to positive net cost impact. The 6-year test window (through 2031) will provide empirical data on whether combined intervention changes the chronic use economics. The BALANCE Model directly addresses the chronic use inflation problem by requiring lifestyle interventions alongside medication. If lifestyle supports can sustain metabolic benefits after medication discontinuation, the model could demonstrate a pathway to positive net cost impact. The 6-year test window (through 2031) will provide empirical data on whether combined intervention changes the chronic use economics.