Omada Health has formed a strategic alliance with CVS Health’s Caremark as part of the pharmacy benefit manager’s comprehensive weight management program. This collaboration represents Omada’s second major partnership with a prominent pharmacy benefit manager (PBM), following its previous arrangement with Cigna’s Express Scripts through their EncircleRx initiative.
Enhanced GLP-1 Care Track Program
At the core of this partnership is Omada’s specialized enhanced care track program for GLP-1 medications. This innovative program aims to simplify the process for employers to provide coverage for these medications while ensuring they’re used effectively. By combining GLP-1 medications with comprehensive clinical oversight and lifestyle modifications, the program drives sustainable weight loss and better management of obesity and related health conditions.
The program offers members access to a holistic suite of support services. These include:
- Guided exercise plans tailored to individual needs
- Behavioral health support mechanisms
- Personalized nutrition coaching
- Comprehensive educational materials
Omada’s clinical team has received specialized training on the optimal use of GLP-1 medications and effective strategies to help patients manage and minimize potential side effects.
Addressing Employer Concerns
Wei-Li Shao, President of Omada, highlighted in an interview with Fierce Healthcare that the significant interest in GLP-1 medications has raised considerable concerns among employers and plan sponsors regarding coverage options. This market gap presented a clear opportunity for Omada to develop a solution that addresses these concerns while providing comprehensive patient support.
“We all know that GLP-1s are kind of the topic du jour for everybody right now, not only in society but, most importantly, with PBMs and employers,” Shao explained.
Building on Existing Success
The partnership with Caremark builds upon the foundation established through the previous iteration of the care track launched with Express Scripts. According to Shao, the program has demonstrated impressive outcomes, including significant weight loss among participants and encouraging data showing that patients are generally maintaining their weight loss even four months after starting the program.
Growing Market Presence
The market response to Omada’s approach has been remarkable. The company has already:
- Managed over 50,000 individuals through its GLP-1 care track
- Established relationships with more than 200 client organizations
Strategic Focus on PBMs
Omada’s strategic decision to partner with PBMs stems from recognizing their unique position in the healthcare ecosystem. PBMs already play a crucial role in managing medication costs and tracking utilization patterns, making them ideally positioned to offer complementary interventions.
“They’re in a prime position to provide companion lifestyle intervention, which overwhelmingly all employers, all clinicians, believe that this is a necessity,” Shao emphasized. “If you’re going to be on a GLP-1, you need support.”
Future Directions in Patient Management
Looking ahead, Shao indicated that Omada’s GLP-1 interventions will likely evolve toward a stronger focus on nutrition as they manage patients in the long term. This approach will need to combine healthy eating practices with robust behavioral health support to address challenges like food cravings and emotional eating that often accompany weight loss journeys.
“It’s going to really not only be a combination of nutrition and food, but how do we help them, from a behavioral health standpoint, address the food noise, the emotional eating cravings that come back?” Shao noted.
This comprehensive approach to weight management, combining medication with lifestyle and behavioral support, positions Omada Health as a leader in the evolving landscape of obesity treatment and management.
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