Employer coverage of GLP-1 weight loss drugs expected to double

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While 81% of human resource decision-makers feel their employees would be interested in GLP-1 weight-loss medications, only 25% cover GLP-1s currently – but that figure is expected to double next year, according to a new survey from Accolade.

GLP-1 medications, originally designed for diabetes management, have skyrocketed in popularity over the past year as an effective drug for weight loss and obesity. 

Three-quarters of HR decision-makers are aware of GLP-1 medications and acknowledge them as beneficial for controlling blood sugar, boosting weight loss, improving blood pressure and lowering the risk of heart disease, among other uses, according to the survey.

WHAT'S THE IMPACT?

While employers seek coverage of Ozempic, Wegovy, and other GLP-1 drugs due to their ability to help people lose weight, some insurers are reluctant because of increasing costs. 

Another obstacle for HR directors is a cited lack of trusted information.

Forty-eight percent of HR decision-makers said lack of information about other uses of the drug has held them back from covering GLP-1s. They identified doctors and medical organizations or publications (37% and 23%, respectively) as information sources they would trust the most.

Thirty-eight percent cited the costs associated with GLP-1s as a potential barrier to providing coverage. Another recent survey by Virta confirmed that high-costs of GLP-1s, driven by an anticipated rise in utilization, are a concern for 72% of health plan leaders.

Despite the barriers, most HR decision-makers are open to adding GLP-1 medications to their benefits package. They believe GLP-1 coverage would enhance employees' health and perception of healthcare benefits: Some 79% agree that GLP-1 coverage will help employees' health long term, while 77% agree that GLP-1 coverage would make employees feel they get a better health insurance package.

The 25% of companies already covering the weight-loss drugs say they plan to continue covering them (99%), providing perspective on balancing financial impact with employee engagement and satisfaction. About one-third reported a strong financial impact from adding GLP-1s, while more than two-thirds reported an increase in enrollment after the medications were added.

The employers also attributed other related and desirable outcomes to adding GLP-1s: higher employee satisfaction/wellbeing (75%); increased engagement in other wellbeing programs (58%); and improvement in other/comorbid health conditions (57%).

Overall, the survey results indicate that cost is not the only reason employers are not providing coverage of GLP-1 medications. HR decision-makers are closely following the surge in demand for the medications, intently considering their plans, and seeking more information to help them reach a decision.

Accolade recommended approaching this decision with ample research from physicians and medical organizations, coupled with an advocacy-led comprehensive care perspective that considers the total cost and beneficial outcomes of well-managed employee health.

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, it could cost the federal program between $13.6 and $26.8 billion annually, a recent 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.

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com