Many cardiac drugs have notoriously low adherence rates, but GLP-1s may be overcoming that problem, according to Northwell Health cardiologist, Jeffrey Wessler, MD.
"It is almost impossible now to manage patients and not have GLP-1s be part of that conversation," Dr. Wessler told Becker's. "In my view, and I think where the evidence is bringing us, is that what started as a medication for diabetics and weight loss is quickly becoming probably one of the best cardiac medications that exists. That's for a fairly simple reason, which is that it may be the first medication that patients actually want to take because it has this amazing side effect of losing weight."
Nonadherence to medications has been documented to happen among more than 60% of cardiovascular patients, according to the American Heart Association. Patients often stop taking cardiac medications due to concerns about side effects, a perceived lack of immediate benefits, high costs, and complex drug regimens.
Adherence issues are common with GLP-1s as well. In May, the Blue Cross Blue Shield Association published research that found 58% of patients taking weight loss drugs discontinue use of their medication before reaching a clinically meaningful health benefit.
Notably, the study found that patients who received a prescription from an endocrinologist or obesity medicine specialist were more likely to stick with treatment, along with those who saw their physician more often, regardless of specialty. Patients with coexisting conditions such as peripheral vascular disease or diabetes, particularly those with three or more similar conditions, were also more likely to continue treatment.
"There are certainly some downstream issues with GLP-1s," Dr. Wessler said. "But for adherence, which is a prime issue for many cardiac medications that work really well in a clinical trial setting, that is not really an issue. People want to take it. It is really transforming how I think about managing an early stage cardiometabolic patient."
"As we continue to face supply issues with these medications, and who should be getting them, the cardiac patients for whom the outcomes are just tremendous are going to be seeing more and more uptake. And there will be more studies coming out showing the benefits for clinical outcomes compared to other therapies available."
Though Medicare is barred from covering GLP-1s for weight loss only, new policies from the FDA and CMS in March led Elevance Health, Kaiser Permanente and CVS Health to become the first Medicare plans to cover Wegovy for seniors with certain heart conditions.
Dr. Wessler shared his thoughts on the Becker's Cardiology & Heart Surgery podcast, an episode that will air later this month. He is a cardiologist at New Hyde Park, N.Y.-based Northwell Health and founder and CEO of Heartbeat Health, the country's largest virtual cardiovascular care company.