Employers in the United States are still hesitant to cover glucagon-like peptide-1 (GLP-1) drugs for weight loss, according to a recent survey report by the International Foundation of Employee Benefit Plans. The survey, conducted in May 2024, revealed that only 36% of employers provide coverage for both diabetes and weight loss, while 55% cover GLP-1s for diabetes alone. Despite the potential benefits of these drugs in promoting weight loss by suppressing appetite and increasing the feeling of fullness, many employers are reluctant to reimburse them due to the impact on their pharmacy budgets.
GLP-1 drugs like Wegovy and Zepbound have been shown to be effective in aiding weight loss by activating the body’s GLP-1 receptors. However, the high cost of these medications has been a barrier to widespread coverage by employers. Insurers like Blue Cross Blue Shield have even reversed their policies on covering GLP-1s for obesity, while others like Cigna are capping out-of-pocket costs for patients using these drugs.
In an effort to make these medications more accessible, pharmaceutical companies like Novo Nordisk have partnered with pharmacy benefit managers like CVS Caremark to offer discounts on drugs like Wegovy. These partnerships aim to reduce the net costs for employers and patients, making it more likely for employers to consider covering weight loss medications in the future.
Additionally, the federal government is working to negotiate prices for GLP-1 drugs like Ozempic and Wegovy, which could result in even lower costs for employers and patients. Direct-to-consumer strategies by companies like Novo Nordisk and Eli Lilly have also made these medications more affordable for cash-paying customers who are not insured for obesity drugs.
Overall, while employers may still be hesitant to cover weight loss medications, the decreasing net costs and increased accessibility through partnerships and direct-to-consumer options could influence their future coverage decisions. As the landscape of weight loss drug coverage continues to evolve, it will be important for employers to consider the potential benefits of these medications in promoting overall health and well-being.
