Will GLP-1 Drugs Wake up the Sleep Apnea Market?

The noise around GLP-1 drugs and their ripple effect on medtech continues to grow louder as clinical data appears to support a growing use case for the drugs.

Initially approved to treat diabetes, glucagon-like peptide-1 (GLP-1) drugs are being heralded to address obesity and, more recently, obstructive sleep apnea (OSA). But even if GLP-1s prove to be disruptive to this medtech sector, the current market leader for CPAP machines is unlikely to be caught resting on its laurels, if management and analyst commentary are any indication.

In April, top-line data from Eli Lilly’s phase III SURMOUNT-OSA trial comparing the efficacy of GLP-1s alone and in combination with positive airway pressure (PAP) in OSA patients over 12 months. Overall results were positive for both arms, with the PAP plus GLP-1 arm showing a 62.8% apnea-hypopnea index (AHI) reduction compared to a 55.0% AHI reduction from GLP-1 treatment alone. The results still managed to spark enough investor fear to trigger a 6% dip in ResMed’s stock the day the results were released.

Analysts like William Blair’s Margaret Kazcor Andrew continue to be bullish that CPAP will remain the gold standard for sleep apnea treatment, with GLP-1 drugs likely to be used as adjunctive therapy.

Related:Hey Medtech, You Need to Calm Down (About GLP-1)

“...As we gather a more complete dataset over time, we expect these results to ultimately conclude that the impact of these drugs on the market should not only be manageable but ultimately help drive awareness of the disease and fuel an increase in the number of patients who ultimately are offered various forms of treatment – in this case, positive airway pressure,” Andrew wrote in a report published on April 18 based on a conversation with Carlos Nunez, MD, ResMed’s chief medical officer, about the SURMOUNT-OSA trial results.

“At a high level, we have long been believers that clinicians should turn to a variety of drugs, devices, and procedures in the treatment of diseases,” Andrew wrote. “These tools work in combination and are often applied differently depending on the patient profile. The GLP-1 drugs are the latest class to show a benefit in patients, this time with OSA, but like other tools have nontrivial side effects, cost concerns, and patient persistence issues that balance out the headline benefits.”

The size of the underlying patient populations, which are expected to surpass 1.3 billion globally by 2050, as well as the under penetration of CPAP treatment, which Andrew ballparks at 15% or less in many markets, reinforces the analyst’s argument.

Related:Abbott CEO: GLP-1 Concerns in Medtech Are Overblown

“No single treatment is likely to overwhelm the demonstrated benefits of CPAP given patient access, complications, and patient falloff that has been observed with the GLP-1 agents to date,” Andrew said.

ResMed CEO: Big Pharma is squarely focused on GLP-1 medications right now

Image courtesy of ResMed

ResMed CEO Mick Farrell’s stance on the issue is that the latest advances in both Big Tech and Big Pharma “can potentially bring incredible numbers of new patients into the healthcare system where ResMed is uniquely positioned to provide ongoing care at home.”

During the company’s first-quarter earnings call, Farrell said the company is laser-focused on growing the market to help people get on the therapy they need and on a pathway to better sleep, better health, and better long-term care.

During the quarter, ResMed introduced its latest sleep apnea mask innovation, the AirFit F40, into the U.S. market. The F40 features a new technology the company calls AdaptiSeal, touted as a silicone cushion designed to create and maintain a better facial seal even as the user moves during sleep. The new mask leverages a fully flexible frame technology to cope with frequent nocturnal movement, according to ResMed.

Related:Are Weight-Loss Drugs the da Vinci Robot’s Newest Competitor?

Image courtesy of ResMed

“Physicians, respiratory therapists, and patients love the F40 for its comfort, its fit, and its ease of use,” Farrell said. “It is the smallest full-face mask on the market from ResMed. Patients are voting with their wallets and respiratory therapists and physicians are voting with their recommendations and their prescriptions.”

Where some medtech leaders might see GLP-1 drugs as a big threat to their territory, Farrell sees it as an opportunity to funnel more people toward CPAP treatment by boosting awareness of chronic diseases like sleep apnea, and driving more people who suffer from these diseases into treatment pathways they may not have been previously open to or aware of, such as CPAP machines. By this line of thinking, he said ResMed expects the GLP-1 trend to drive not just more patients into the company’s channel, but also more motivated patients into its channel.

“Big Pharma is squarely focused on GLP-1 medications right now. For many people dealing with their obesity, their healthcare goals are focused on losing weight while improving their diet, exercise, and their sleep routines,” he said. “We believe that increased utilization of GLP-1s to treat obesity will bring many new people into the healthcare funnel, activating them to see their primary care physicians as they strive for weight loss and other medical health.”

Image courtesy of ResMed

ResMed has been tracking the impact of GLP-1s through a de-identified patient analysis using an overlap of its own data and third-party claims data, Farrell said during the earnings call. He said the company has now analyzed data on up to 660,000 subjects and the bottom line is that the data show GLP-1s are having a positive impact on patients seeking and adhering to positive airway pressure therapy.

“The latest numbers are an improvement from what we presented previously. For patients prescribed a GLP-1 medication, the latest data show a 10.5% higher propensity to start positive airway pressure therapy over those not taking the drug,” Farrell said. “These data show clearly that these new GLP-1 pharmaceutical class is actually a tailwind for our ResMed business, bringing more patients and more motivated patients into the healthcare system.”