Dive Brief:
- While nearly 7 in 10 companies cover GLP-1s for weight management, that share is expected to fall next year, according to the results of a survey released Tuesday by the Business Group on Health, a healthcare policy advocate for employers.
- Of those offering the coverage, only 72% said they were likely to do so in 2027, and 10% said they likely wouldn’t, the survey found. Companies without the coverage are unlikely to add it.
- Employers are worried about containing rising healthcare costs, and nearly 8 in 10 surveyed said GLP-1s are driving up their spend.
Dive Insight:
Employers have “tremendous concern” about the financial viability of these medications, Ellen Kelsay, president and CEO of the Business Group on Health, said in a news release.
“Against the backdrop of anticipated double-digit health care cost increases, fueled to a large degree by GLP-1s and overall prescription drug costs, companies cannot ignore the reality that GLP-1s have significant implications for health care budgets — and overall affordability,” Kelsay said.
To manage costs, many companies put in place guardrails “to ensure the appropriate use” of GLP-1s to manage weight, the survey found. These include checking clinical eligibility using objective biometric data, mandating participation in a weight management program, limiting prescribing to certain providers and excluding certain medications from the formulary.
However, even these requirements don’t do enough to ease “cost pressures” on some companies’ healthcare budgets, per the survey, which included responses from 105 employer members of the Business Group on Health fielded in February and March.
Mercer in November predicted that employers and employees would confront a “healthcare affordability crunch” amid rising costs. Part of the increase can be attributed to the growth in prescription drug spending, including for expensive GLP-1 weight-loss medications, Mercer’s survey found.
More than a third of GLP-1 users surveyed by the Employee Benefit Research Institute said they had stopped taking a GLP-1 medication, a survey released in March found. Four in 10 cited cost, while about 1 in 7 pointed to a lack of coverage for the medication, EBRI said.