GLP-1 Medications and Employer Considerations
In the ever-changing employee benefits landscape, employers looking to attract and retain talented employees want to be at the forefront of the advances. At the same time, companies need to control costs and address employee needs while complying with a myriad of state and federal law.
Popular culture has always wielded an enormous influence on individual preferences, and now seems to be finding a foothold in employee benefits. For example, direct to consumer advertising of pharmaceuticals on cable television has had an impact on employer health plans, as evidenced in higher prescription weight loss medication demand than ever before. A class of medications known as GLP-1 drugs have long been used to treat Type 2 diabetes. When it became apparent that these drugs also caused individuals to lose a percentage of their body weight during treatment, their popularity skyrocketed.
The International Foundation of Employee Benefit Plans reports in a 2023 survey that 76% of surveyed employer health plans provided GLP-1 drug coverage for diabetes, versus only 27% that provided coverage for weight loss without a Type 2 diagnosis. Another 13% of plan sponsors indicated they were considering adding coverage for GLP-1 drugs for weight loss.
Whether or not these expensive medications are covered by employer plans varies widely and depends on factors such as individual diagnosis, provider education, plan design and plan funding. At the time of this writing, there is no federal or state law that directly requires these medications be covered for obesity by employer plans. Obesity is a health risk, and is associated with other potentially costly health conditions. Health insurers must weigh the cost of covering these drugs against the potential costs incurred by a population of individuals with untreated obesity. Wellness programs targeted at weight loss and health maintenance may be a more affordable first step for employers wishing to meet their employees’ needs. But with the rising popularity of these medications, employers are facing increased pressure from their workforces to cover GLP-1 drugs for obesity. This is a trend that will be important to watch in the coming months.