News
Capital BlueCross: Should GLP-1 Drugs Be Covered? 4 Facts for Employers to Consider
There’s a surge in demand for drugs like Ozempic, Wegovy, and Zepbound for weight loss. If you’re an employer considering whether to cover these drugs for your employees, taking a comprehensive look at your healthcare coverage can help you decide.
Employers have a vested interest in keeping their employees healthy, and employer decisions about healthcare coverage can play a major role in improving employee wellness.
The rising popularity of medications like Ozempic, Zepbound, or Wegovy as weight management drugs has piqued the interest of employers and employees alike. The drugs – technically known as glucagon-like peptide 1 receptor agonists, or simply GLP-1 drugs – have long been used to treat diabetes but are relatively new as weight loss medications.
If you’re considering covering these types of drugs for weight loss, there are a few issues you might want to weigh:
What to Consider about GLP-1 Coverage
GLP-1 coverage can be costly
GLP-1 drugs can cost more than $1,000 per month for an individual, and users of GLP-1s need to stay on the drugs long-term or the weight comes back. Those who stop taking them typically regain two-thirds of the weight they lost within a year. The hefty and recurring cost has led some employers to end or restrict coverage of GLP-1 drugs due to concerns about affordability for both employees and their businesses.
Side effects might affect productivity
It’s well-documented that obesity can be a cost driver in employee healthcare, fueling absenteeism and undermining productivity. But GLP-1 drugs also have concerning and risky side effects – ranging from nausea, vomiting, and diarrhea to depression – that can lead to absenteeism or lost productivity.
Some have trouble staying on GLP-1s
Whether it’s due to high cost, unwanted side effects, or both, the majority of people who start using GLP-1 drugs stop taking them before they see any meaningful health benefit. This can mean a costly expense with no tangible result.
A drug alone won’t keep the weight off
GLP-1 drugs generally are not considered a standalone treatment for obesity, which often requires individual, comprehensive medical strategies and lifestyle changes. Exercise, behavioral changes, and even mental health counseling can be helpful to maintaining a healthy weight – and your healthcare plan can help make the difference.
How Capital Blue Cross Can Help
If you’re an employer considering (or reconsidering) whether to cover GLP-1 drugs for your employees, taking a comprehensive look at your healthcare coverage can help you decide.
Capital Blue Cross, for instance, can provide in-depth consultations to employers who have its group coverage. Capital’s medical experts examine cost and utilization data in addition to population health metrics to help employers identify healthcare-related issues impacting their employees. In addition, Capital can provide details regarding the prevalence of diabetes, high blood pressure and other conditions associated with being overweight to help employers make coverage decisions.
This insight can help businesses identify the most affordable, effective healthcare benefits and programs and better manage and support employee health and wellness.
For individuals, Capital offers tools to lose weight, prevent diabetes, and even manage or reverse Type 2 diabetes. Capital also offers a wellness program that gives your employees financial incentives simply for taking care of themselves.
Medications like GLP-1 drugs might be a helpful tool for some, but there are a host of other health and wellness resources available for your employees – and your business.