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October 2023  Volume 21, Number 10        
 

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Are Weight-Loss Drugs The Next Big Benefit?

With nearly half of American adults saying they would be interested in taking prescription weight-loss medications if covered by insurance, employers may soon face rising pressure to provide coverage for these drugs in their health plans. But concerns around safety, efficacy and costs are giving some employers pause.

Demand Driven by New Medications, But Interest Plummets with Caveats

According to a new survey from the Kaiser Family Foundation (KFF), 45% of adults reported being interested in using weight-loss prescription drugs if they were covered by insurance. This demand is being fueled in part by a new wave of medications like Wegovy, which promise significant weight loss in patients.

However, when told of potential drawbacks and uncertainties surrounding the drugs, interest dropped off sharply. Only 15% said they would take the drugs if insurance didn't cover the cost, while just 16% were interested if the Food and Drug Administration had not approved the medication specifically for weight loss purposes. Wegovy remains the only drug officially approved by the FDA for chronic weight management.

Employers Cautious Amid Safety Worries, But Pressure Building

Even with concerns around safety and long-term effects, employers are increasingly likely to hear requests from their workforce to cover weight-loss prescription medications in their health plans.

Most experts say more research is needed to fully understand the potential consequences of taking these drugs, especially for extended periods of time. Their high costs are certainly a factor, with Medicare currently not covering weight-loss drugs and some employers already reportedly limiting coverage.

In KFF's survey, 80% said insurers should cover the medications for individuals diagnosed as obese. But only 53% supported broad coverage for any adult looking to lose weight, signalling more limited worker interest in universal coverage by employers.

Strategies for Employers to Navigate Potential Minefield

As employers weigh how to respond to this emerging benefit demand, experts suggest a measured approach. Consulting physicians and researchers directly can help them assess the latest safety and efficacy data to make informed coverage choices.

Surveying employees about their desires may provide some valuable insights. Companies could consider initially offering limited coverage for employees with an obesity diagnosis, and after evaluating utilization and costs, consider expanding coverage.

Clear communication on why coverage is being provided or restricted is key to set appropriate expectations. And staying abreast of the latest studies will ensure decisions are based on current evidence.

Creative benefit design solutions could also help balance costs with worker interests. This may include requiring step-therapy approaches, restricting coverage to certain medication types or capping the duration of covered treatment.

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In this issue:

This Just In ... Rethink Your Healthcare Offerings for Healthier, Longer-Lived Employees

Seven Strategies for Helping Employees Understand Their Benefits

Preventative Health Helps Cut Costs without Cutting Care

On-Demand Pay Reduces Employee Financial Stress

Are Weight-Loss Drugs The Next Big Benefit?

 

 


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