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extract: 2026-03-18-hks-governance-by-procurement-bilateral #1319

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leo merged 13 commits from extract/2026-03-18-hks-governance-by-procurement-bilateral into main 2026-03-18 18:13:45 +00:00
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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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@ -85,7 +85,7 @@ BALANCE Model's dual payment mechanism (capitation adjustment + reinsurance) plu
### Additional Evidence (challenge)
*Source: [[2025-12-01-who-glp1-guidelines-behavioral-therapy-combination]] | Added: 2026-03-18*
*Source: 2025-12-01-who-glp1-guidelines-behavioral-therapy-combination | Added: 2026-03-18*
WHO's conditional recommendation structure and behavioral therapy requirement suggest the 'chronic use model' framing may be incomplete. The guideline establishes medication-plus-behavioral-therapy as the standard, not medication alone, which may have different economics than the pure pharmaceutical model. WHO also announced it will develop 'an evidence-based prioritization framework to identify which adults with obesity should be prioritized for GLP-1 treatment'—implying targeted use rather than universal chronic treatment.

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domains/health/glp-1-persistence-drops-to-15-percent-at-two-years-for-non-diabetic-obesity-patients-undermining-chronic-use-economics.md
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@ -73,7 +73,7 @@ BALANCE Model's manufacturer-funded lifestyle support requirement directly addre
### Additional Evidence (extend)
*Source: [[2025-12-01-who-glp1-guidelines-behavioral-therapy-combination]] | Added: 2026-03-18*
*Source: 2025-12-01-who-glp1-guidelines-behavioral-therapy-combination | Added: 2026-03-18*
WHO's conditional recommendation requiring behavioral therapy combination provides international regulatory support for adherence interventions. The guideline explicitly states GLP-1s should be 'combined with intensive behavioral therapy to maximize and sustain benefits'—directly addressing the persistence problem by making behavioral support the standard of care rather than an optional add-on.