St. Louis-based Ascension has dropped coverage for weight loss drugs such as Wegovy from its employee health plan.
Ascension employs about 139,000 people and operates 139 hospitals in 19 states. The new coverage policy was effective July 1 and came after a review of the "safety, long-term outcomes, national coverage benchmarks, and cost-effectiveness" of weight-loss and anti-obesity prescription drugs, the health system wrote in an online update.
Ascension employees must now pay out-of-pocket for GLP-1s such as Wegovy and Saxenda, which are FDA-approved for weight-loss, along with Adipex, Alli, Benzphetamine, Contrave, Diethylpropion, Imcivree, Lomaira, Orlistat, Phendimetrazine, Phentermine, Plenity, Qsymia, Resveratrol, and Xenical. The coverage exclusion will also apply to new weight loss drugs that become available in the future.
GLP-1 drugs come with a steep price tag, costing upwards of $10,000 per year without insurance. As demand continues to surge, the nation's largest payers told investors in the first quarter that coverage of GLP-1s has been almost entirely constrained to diabetes care. In a June survey from the Pharmaceutical Strategies Group, 49 percent of plans surveyed said they currently cover medications for weight loss, compared to 41 percent of employers.
A federal bill filed July 20 aims to lift the current ban on Medicare coverage of weight loss drugs.