Addressing obesity requires more than covering GLP-1s for weight loss 

Addressing obesity requires more than covering GLP-1s for weight loss
May 15, 2024

Obesity is more than weight. It's time to shift the narrative and recognize obesity for what it truly is – a multifaceted disease with significant implications for both individuals and employers. 

Obesity is not simply a matter of overeating or lack of willpower. It's a chronic medical condition influenced by a complex interplay of genetic, environmental, and behavioral factors. From hormonal imbalances to socioeconomic disparities, there are numerous drivers behind the rising rates of obesity globally. Being aware of these underlying factors is key to creating strategies to support employees' health and well-being.  

Historically, many employers considered weight-loss drugs as cosmetic or lifestyle drugs and excluded them from coverage. As GLP-1s started cropping up on social media and TV ads in 2023, employers faced increased pressure to cover drugs like Wegovy, Saxenda, and Zepbound. According to Mercer’s National Survey of Employer-Sponsored Health Plans, 42% of large employers cover weight-loss medications, with the majority imposing prior authorization requirements. Over the past year, utilization of GLP-1s has become the number one driver of non-specialty pharmacy trend. This new demand is causing upward pressure on healthcare costs that were already rising. 

These medications represent a big investment. GLP-1 medications used for weight loss carry an average price-tag of around $800 per month (after discounts and rebates), meaning a year of persistent treatment costs roughly $9,600. With additional GLP-1s in the drug development pipeline, and potential new indications for cardiovascular disease, addiction, liver disease, and fertility, employers should plan on continued growth in spending on this class of medications for the foreseeable future. Despite these headwinds, there are both established and emerging tactics to mitigate the short- and long-term costs of these medications, while providing employees equitable access to the treatment that best meets their needs. The benefits of covering GLP-1s for weight loss may well be worth the cost. When asked about their future plans for covering weight-loss medications in our soon-to-be-released Survey on Health and Benefit Strategies for 2025, employers were more likely to be considering adding coverage than dropping it. 

The employer role in helping employees living with obesity

One of the most significant impacts of obesity in the workplace is its association with various chronic conditions, including type 2 diabetes, cardiovascular disease, musculoskeletal issues, and certain cancers. These conditions not only affect employees' health but also result in increased healthcare costs and decreased productivity. Conversely, addressing obesity improves individual health outcomes contributes to a more productive workforce. 

Moreover, obesity can have profound implications for mental health and well-being. Individuals living with obesity often face stigma and discrimination, both in society and the workplace. This can lead to decreased self-esteem, increased stress, and even depression. Fostering a culture of inclusivity and support, where all employees feel valued and respected, regardless of their size, is an important way to support employees living with obesity. 

From a benefits perspective, addressing obesity requires a multifaceted approach that goes beyond traditional weight loss programs. While diet and exercise play important roles, interventions need to be holistic and tailored to individual needs. This may include access to counseling services, nutritional support from a registered dietitian, or access to a pharmacist to monitor for patients on multiple medications. Many employers are considering access to these types of engagements by partnering with a vendor tailored to meet the needs of patients in this disease state.  

A number of Pharmacy Benefit Managers (PBMs) have created buy-up programs to aid with obesity management. Components often include nutritional support, lifestyle management and higher Body Mass Index (BMI) to qualify for GLP-1s. In our new survey, employers showed strong interest in these programs, but it’s important to assess them carefully to determine the best fit for your population. Evaluation should include the financial impact as many of these programs affect rebates and may reduce or fully erode any potential cost savings relative to traditional management. Employers should consider current programs in place with the medical carrier or point solutions to ensure there is no duplication or member confusion if implementing a PBM program.  

Whatever the source, a comprehensive wellness program should include a robust cardiometabolic strategy that empowers employees to take control of their health and reduce their risk of obesity-related complications. GLP-1s can be part of the solution, but they are not the whole solution.  

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