CarelonRx launching digital-first weight management program
The program will provide access to coaching and wellness tools to help participants manage their weight goals.
Photo: Kseniya Ovchinnikova/Getty Images
Beginning this spring, CarelonRX, will launch a weight management program to provide support to members who are on weight loss journeys – including those who use GLP-1 medications. CarelonRx is the pharmacy services segment within Carelon, Elevance Health's health services division.
The digital-first program will provide access to digital coaching and wellness tools meant to help participants manage and monitor their weight goals, with the ability to connect to live human support, both digitally or over the phone.
Behavioral health and social drivers of health screenings will also be incorporated to ensure whole health is the central component of the personalized wellness plans.
WHAT'S THE IMPACT?
By 2030, about half of adults in the U.S. will be considered to be obese, and about a quarter of adults will have severe obesity, according to a study in the New England Journal of Medicine. On top of that, more than 49% of U.S. adults have tried to lose weight in the past year, and 45% of American adults are interested in taking a prescription weight loss medication.
For participants who are prescribed GLP-1 medications to aid in their weight management, the program will feature a GLP-1 companion module that is designed to provide medication management support with a member's prescribing physician.
The weight management program will be available to ASO integrated clients.
CarelonRx President Paul Marchetti said the goal is to ease the complexities of weight management and support healthier overall lifestyles.
""Our weight management program is unique because it considers a member's whole health needs, including pharmacy, medical and social drivers of health data, and creates opportunities for care coordination between nutrition and exercise experts, pharmacists, physicians and health plans," he said.
THE LARGER TREND
Buzz around GLP-1 weight-loss drugs such as Novo Nordisk's Ozempic and Wegovy is growing, but if patient demand continues to grow, and Medicare expanded its coverage in response, the results could cost the federal program between $13.6 and $26.8 billion annually, a 2023 KFF analysis found.
Manufacturers of weight-loss drugs, such as Novo Nordisk and Eli Lilly, are pushing for a change in law to allow coverage under Medicare, despite uncertainty about the risks of using the drugs.
That would come at significant cost to Medicare, the analysis found. Wegovy, for example, has an annual estimated net price of $13,600.
According to a recent study in the New England Journal of Medicine, if 10% of Medicare beneficiaries with obesity used Wegovy, the annual cost to Medicare could range from $13.6 billion – based on a 19% obesity rate from traditional Medicare diagnoses in 2021 – to $26.8 billion, based on a 41.5% obesity rate from survey data for adults ages 60 and older. Higher take-up rates would mean higher Medicare spending.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
