How Employers Incorporate Lifestyle Treatments into GLP-1 Coverage

Approximately 40% of the U.S. population is obese, and a promising drug that has entered the market in recent years may provide a solution.

This class of drugs, called GLP-1, has long been prescribed to treat diabetes, but can now also be used for weight loss. Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound are two of his GLP-1s approved by the Food and Drug Administration (FDA) for weight loss purposes.

The cost of these drugs is estimated to be $1,000 per patient per month, and the question of whether to cover these drugs is especially pertinent since nearly 60% of Americans rely on employer health insurance. Relates to the US workplace. Most HR decision makers (81%) researched by Personalized healthcare company Accolade said last fall that it felt its employees were interested in GLP-1, with 43% saying they intended to cover the drug by 2024, up from 25% in 2023. Ta.

Healthcare companies currently working with employers who cover GLP-1 for weight loss purposes argue that drugs alone are not a silver bullet and emphasize the combination of drugs with other lifestyle treatments.

How Labcorp covers GLP-1. Healthcare company LabCorp has covered GLP-1 for patients with type 2 diabetes through its Pharmacy Benefits Manager (PBM) benefits package for nearly a decade, chief medical science officer Brian Cavenney told HR Brew. Once the FDA approved the drug’s indication for weight loss, it seemed like a natural extension for the company to cover those indications, but Caveny’s team has found that it is appropriate for workers who are prescribed the drug. He said that he wanted to make sure that they were providing appropriate clinical support.

“We think it’s important that we don’t just release our employees into the outside world and say, ‘Good luck with this $1,000-a-month drug,'” he says.

Labcorp has begun providing clinical support through an expanded partnership with WeightWatchers for Business announced on February 7th. With this new investment, U.S. employees using GLP-1 will have access to virtual care and medication management through his WeightWatchers. Eligible employees can prescribe medications through their physician or WeightWatchers.

Weight Watchers’ GLP-1 program, launched in December, is designed to help patients who are taking medications for weight loss, whether or not they have a prescription through a Weight Watchers doctor, succeed. said Amy Meister, the brand’s chief medical officer. . Research suggests these drugs are more effective when combined with physical activity and dietary changes, so current FDA labeling recommends “prescribing them concurrently with behavioral and lifestyle treatment plans.” Meister explained. WeightWatchers provides nutritional guidance and exercise activities with strength training based on these recommendations.

Omada Health, another company that provides virtual support to patients receiving GLP-1 through their employer, is taking a similar approach in its program. In May 2023, Omada launched a special program for members taking GLP-1 featuring lifestyle change resources and community support. Recently, Omada added an “enhanced musculoskeletal exercise program” to its products, as it has been shown to help patients maintain weight loss even after they stop taking it.

“We believe that muscle loss and lack of fitness after discontinuing GLP-1 is an important reason why people gain weight back,” said Carolyn Bradner Jusik, Omada’s chief medical officer. said about the addition of this program. She said: “We believe there is a huge opportunity to focus on holistic lifestyle and monitoring to support weight maintenance in people who choose to come off medication.”

Monitor medications carefully. Omada, president of the company, said the company is encouraging employers to approach GLP-1 coverage holistically, incorporating not only lifestyle programs but also treatment for related conditions such as diabetes, high blood pressure and high cholesterol. Wei Lei Xiao said.

“I want to force HR leaders to think more broadly,” Hsiao said. “Why implement a weight loss-only solution that doesn’t integrate with your existing weight management, diabetes prevention, hypertension, and diabetes programs?….What you really want is a GLP-1 program or a health management track. Unfortunately, this is the case for most people in the United States.”

Bradner-Jusik and Hsiao say that pharmacy benefits managers have access to data that helps inform employers about how to achieve the best health outcomes while controlling costs, which can be valuable in benefit design. He said he could become a consultant.

LabCorp recognizes the fact that investing funds in GLP-1 may deprive you of other employee investments, such as raises and other benefits, and LabCorp does not offer employee-based access to GLP-1. It said it would closely monitor the situation and compliance.

“Like other payers and employers who are shouldering that cost, we want to be extremely responsible,” Caveny said. “We’re watching very, very closely.” [the] Utilization, its appropriateness, continuation of medication… and most importantly, compliance with this new drug. [WeightWatchers] This is a program that we just launched. To that end, he will work closely with PBMs and WeightWatchers.