Weight Loss Meds Spurring Insurance Coverage, Raising Behavioral Questions
More unions and employers are starting to cover the new wave of weight loss drugs called GLP-1s, and for more than just those with type 2 diabetes. Policies set to roll out in 2024 are part of an effort by unions and self insured employers to recruit and retain employees. The coverage expansion of what is a $10-16K a year medicine is noteworthy. Pre-authorization is required to make sure people need the medicine and will remain in place for foreseeable future, but the medicine has potential to have a ripple effect, on cardiovascular disease prevalence and management, potentially depression and anxiety and maybe on pain and productivity. One national union health plan we interviewed last week spent $150K on GLP-1s alone in 2022 for a small group of its members, compared to the $1.6M it spent overall for weight loss, an $840K increase vs. 2021. There are many new GLP-1 drugs in the pipeline so plans expect to see use increase year over year, and there is a big push for these medicines to get approved for more than just those with type 2 diabetes. “The big question is ‘to what end,’” said utilization analyst Wendy Abraham on our conference call November 10th. “Down the road, we may work it out so that members may also need to enroll in a program of counseling since these drugs may be lifetime usage.”
There are several behavioral health implications here to consider:
Will the medicines reduce anxiety and depression?
Will they allow people who previously were not exercising much to increase activity levels, further improving both cardiovascular and mental health?
Will there be a negative adverse side effect of the medicines such as unintended anxiety and depression?
Will employers and other insurance companies continue to cover these medicines?
How will they be able to afford them and for how long can they cover?