The high cost of GLP-1 drugs have thrown a curveball at payer strategy. Employers providing health insurance are also grappling with the fallout.
From January to July, Davis Research interviewed business owners and human resource and benefits managers at 1,862 firms for KFF. Some interviews addressed GLP-1 coverage for weight loss. For these questions, the researchers focused on organizations with at least 200 employees.
Here are five notes on how employers are handling GLP-1 coverage for weight loss:
1. The larger the company, the more likely it is to cover GLP-1 agonists for weight-loss use cases: 16% of firms with 200 to 999 workers, 30% of firms with 1,000 to 4,999 workers and 43% of firms with 5,000 or more workers offer this coverage.
2. About one-third of the firms that cover GLP-1 agonists for weight loss require enrollees to consult with a dietitian, case manager or therapist — or join a lifestyle program — to qualify for coverage of the prescription.
3. The majority of employers with at least 5,000 workers said covering these agonists had a “significant” impact on health plan prescription drug spending. Firms with under 1,000 workers were more likely to consider it “minor.”
4. Out of the organizations that cover GLP-1s for weight loss, 37% said it is “important” to employee satisfaction, while 26% said this coverage is “very important.”
5. The firms that do not currently cover GLP-1s for weight loss are not likely to do so soon. Only 1% said they are “very likely” to cover them in the next year, while 67% said “not likely.”
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