An annual report by pharmacy benefit consulting company Pharmaceutical Strategies Group (PSG) found that 43% of employers currently cover FDA-approved weight loss drugs, while an additional 28% are considering doing so in the next one to two years.
The report surveyed over 150 employers and health plans. Small and large employers are equally likely to cover these medications currently (42% and 40%, respectively). However, small employers are less likely than large employers to be considering this coverage (20% and 36%, respectively).
Although the American Medical Association recognized obesity as a disease in 2013, according to the PSG Report, employers are still divided over whether obesity is a lifestyle choice that should not be covered (24%) or a chronic condition that should be treated (21%). Other reasons employers choose to not cover weight loss drugs include:
- The medications are too expensive, often costing more than $10,000 per individual per year.
- There are concerns that the medications may not lead to long-term weight loss.
- The medications would need to be taken for an indefinite duration.
Additional Information in the Report About Weight Loss Drugs
The report also found that 22% of employers that cover FDA-approved weight loss drugs require employees to participate in a lifestyle modification program. For 20% of employers, participation in such programs is voluntary. The report further found that 16% of employers that cover weigh loss drugs monitor the results achieved from the drugs. However, another 36% plan on implementing such measures in the future.
Finally, the report found that only 14% of employers place limitations on weight loss drug coverage, such as cost or duration of treatment.
Employer Takeaway
The popularity of weight loss drugs has reached a fever pitch in the United States, with more employees than ever inquiring about these medications. As a result, employers are faced with the difficult decision of whether to cover these expensive medications.
The PSG report shows that employer responses to weight loss medications differ. Understanding these trends can help employers decide what’s best for their organizations and their benefits plans.
Contact RMC Group for more employee benefits resources at 239-298-8210 or rmc@rmcgp.com.
This article is of general interest and is not intended to apply to specific circumstances. It should not be regarded as legal advice and not be relied upon as such. In relation to any problem which they may have, readers are advised to seek specific advice. © 2023 Zywave, Inc. All rights reserved.
