The end of shortages on Ozempic, Wegovy, and other semaglutide injections could place added pressure on self-funded health plans to cover the costs of the high-priced medications.
On February 21, the FDA confirmed that the supply of GLP-1 drugs used to treat obesity and diabetes now meets or exceeds both the current and projected U.S. demand. With production ramped up, so too will be a likely effort by drugmakers to encourage their use, says Marc Sweeney, Founder & CEO of Profero Team.
“Now that supply has caught up with demand, you can be certain that Novo Nordisk and Eli Lilly will be increasing their marketing efforts of GLP-1 availability through a variety of approaches, including direct to consumer advertising…. and consumers seeing the ads will in turn be pushing their employers to add obesity drugs to their pharmacy plans,” Sweeney commented. “The pressure to cover Wegovy and Zepbound will only intensify in the coming months.” [Emphasis added]
GLP-1 drugs’ ability to help patients with weight-related health issues has already made it highly sought after, despite a monthly cost often exceeding $1,000. In addition to weight loss, drugmakers have promoted such purported ancillary benefits as reduced risk of heart disease and type 2 diabetes. But the drugs also carry numerous potential side effects as well as increased pancreatitis risk.
“It really comes down to whether the advantages of GLP-1s outweigh its costs and potential side effects,” Sweeney noted. “But employers should keep in mind that these drugs don’t cure obesity. Individuals must make lifestyle changes or the drugs must continue to be taken for any weight loss to remain.”
Despite the greater availability and increasing pressure, MedBen continues to not recommend that clients cover the cost of obesity drugs for weight loss. Other measures, such as medically-guided diets or lifestyle changes in combination with other medications and therapies, should be explored first.