Premiums for employer-provided coverage could increase by about 5% to 14% for employers that cover GLP-1s, according to an Oct. 9 analysis from the Employee Benefit Research Institute.
With 55% of employers covering GLP-1s for diabetes and 36% for both diabetes and weight loss, premium costs are a growing concern. This range is based on real-world drug costs and varies based on adherence, cost-sharing models and eligibility.
Currently, GLP-1s cost between $617 and $766 each month. If GLP-1s got cheaper, premium increases would range between 1% and 4%.
Long-term usage of GLP-1s is necessary to maintain weight loss and cardiovascular benefits, but consistent use also drives up costs, at least in the short term.
“While GLP-1s may eventually generate some medical cost reductions, these benefits would not be manifested immediately, and there is no evidence to suggest that the savings would fully offset GLP-1 prices,” the analysis said.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.