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Balancing Weight-loss Medication Cost and Care

How employers are optimizing weight-loss medication cost and coverage

Nowadays, healthcare costs in the employer space feel a bit like standing on shifting sand. Right now, more than one-third of full-time employees in the U.S. are affected by obesity, and that number is expected to rise. So, are weight-loss medications like GLP-1s a healthcare holy grail? Not exactly – these medications have brought unprecedented health outcomes and health costs. With the volume of people affected by obesity, the cost goes beyond individual concern. Not only are GLP-1s expensive, but medical claims for individuals with obesity are double that of their counterparts. Businesses are now faced with tough decisions on how to foster a healthier workforce despite rising healthcare costs. 

The rocky financial terrain

The obesity cost challenge is complicated, with many, many factors. One issue is the strong connection between obesity and expensive chronic diseases like diabetes and heart disease. Ninety percent of the nation’s annual healthcare spend is due to chronic health conditions that are directly tied to obesity. These statistics may seem daunting but it’s not all bad news. The silver lining is that we know what works in obesity treatment – behavior-change programs and weight-loss medications. These proven methods do more than increase the health, happiness, and productivity of employees – they’re ways to cut down on risk of chronic health issues and decrease claims costs.

Leveling up with weight-loss medications

GLP-1 medications are groundbreaking – but not because they help drop pounds. It’s (surprisingly) not about weight loss, it’s the proven impact on a wide range of chronic conditions – like diabetes, heart disease, liver disease, and more. And keep your eye on the horizon – as new studies are in the works right now for dementia, kidney function, and more. By integrating GLP-1 and other weight-loss medications into their comprehensive obesity-management programs, employers can decrease healthcare spending and increase employee health outcomes.

How employers can have a more effective weight-loss medication strategy

Here’s how employers can better harness the power of weight-loss medications while keeping their costs contained:

  • Full spectrum of weight-loss medications: GLP-1s are in the headlines, but are they the best option for people looking for medically assisted weight loss? Not necessarily. Which is why it’s important to consider other FDA-approved options that are more cost-effective (excluding compounded drugs due to the associated risks). By offering a comprehensive selection of these medications, employers can ensure that employees receive personalized medications that best fit their individualized needs, ultimately driving better health outcomes.
  • Behavior change as foundation: Behavior-change programs (and a good one at that) can make or break the success of weight-loss medications, especially for long-term results. Behavior change is foundational to an organization’s healthcare initiatives – employers can empower employees to make lasting lifestyle changes that not only help shed pounds but improve overall health and well-being.
  • Step therapy program for medications: One key element for weight-loss medications? The most powerful GLP-1 shouldn’t necessarily be first resort. Instead, step therapy allows employers to find a balance between cost-effectiveness and quality of care. By starting with less expensive medications, employers can ensure that employees receive the treatment that’s best for them while also keeping healthcare costs controlled.
  • Personalization: The variety of options – different types of medications, different methods, different support – makes personalization one of the most power tools employers can use to cut costs. Customized treatment means increased employee engagement, better adherence to treatment plans, and (most importantly) better short-term and long-term health outcomes.

Additional considerations for employers

Obesity is a complicated issue, with many factors to consider for an organization’s weight-management program. Other considerations include:

  • Employee education and engagement: People don’t know what they don’t know – and that includes employee benefits. Providing education about the availability of wellness programs through internal communications (emails, newsletters, flyers, polls) foster a culture of health and well-being in the workplace. And it’s not just employer efforts. Look into your current solution – do they have extensive resources and communications? Providing employees with the knowledge and tools they need to make informed decisions about their health empowers them to take control of their well-being.
  • Provider quality and collaboration: Programs are only as good as their experts, and obesity experts are few and far between. Look into their training and certifications – do they have extensive knowledge about obesity treatments? Do they use a variety of medications and methods to personalize treatment plans? One-size-fits-all approaches not only don’t work, but they also let the most vulnerable populations fall through the cracks. 
  • Addressing stigma and bias: This is a big one. Weight bias, stigma, and self-blame are extremely pervasive and have a drastic negative impact on obesity treatment. So, what can employers do? It starts with culture – an empathetic, supportive environment means employees feel comfortable seeking healthcare support without fear of judgment and/or discrimination.
  • Long-term sustainability: Investing in preventive care is a playing the long game – and can impact healthcare claims for years to come. But how can employers ensure that obesity-treatment initiatives will stand the test of time? Two things – behavior-change and past data. If there’s no foundation of behavior-change support, there’s no way it will work in the long run. Period. As for data, look for solutions that can walk the walk – past case studies, long-term results, etc. 

The excitement of these new medications brings a new edge against the complexities of obesity – and with it, new opportunities for increased employee well-being. By being strategic with their obesity-management efforts, organizations can use these powerful interventions in a way that helps both the health of their people, and their bottom line.

Photo: Peter Dazeley, Getty Images

Scott Paddock is the CEO of Wondr Health, the proven leader in metabolic, emotional, and physical health transformation for everyone through behavior change. Paddock leads Wondr Health's efforts to engage populations, improve quality of life and health outcomes, and prevent and reduce the cost of chronic health conditions.

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