McGohan Brabender on the Impact of GLP-1s:

What it means for employers looking for long-term wellness management.

For most employers, unhealthy weight can be tied to ongoing, catastrophic claims impacting annual benefits spending. Over time, employers can face difficult decisions like benefit reductions, absorbing large increases, or passing more costs to employees. For those employers struggling with obesity and diabetes within their employee population, GLP-1 (Glucagon-Like Peptide-1) medications, such as Wegovy and Ozempic, are a welcome addition to available treatment options. But it’s not as simple as just covering the cost of the medication.

Historically, GLP-1s have been recognized as a class of medications used to help manage Type 2 diabetes. However, they have recently been approved for obesity treatment, making them a promising option for those struggling with weight loss. According to Dr. Jeff Eichholz, Vice President of Pharmacy Solutions at McGohan Brabender, organizations looking to address the growing demands of GLP-1s as weight loss management tools need to look internally at their own culture surrounding health and wellness.

“You first must decide whether weight loss medications are a covered benefit through the plan. These therapies may help avoid more costly cardiovascular, musculoskeletal, and cancer claims down the road, but the upfront cost of these medications is still very high.” – Dr. Jeff Eichholz

Employers deciding to cover these drugs will need a Pharmacy Benefit Manager (PBM) who can implement and manage clinical guidelines such as a BMI of 30 or higher or a BMI of 27 with other comorbidities. According to Eichholz, “We want to be cautious of patients just looking for a quick drop in weight. That’s not the intended use of these medications.”

To support those on a weight loss journey, nutritional counseling, exercise initiatives, and incentives are additional considerations for organizations to incorporate in addition to medication coverage.

So, what does this mean for the future? Diabetes, obesity, and GLP-1s will continue to make headlines as the industry evolves and new drugs enter the market. Employees will increasingly ask about coverage status and look to employers for access. McGohan Brabender recognizes the challenges employers face when navigating these changes and has created a dedicated team to address the future demands for pharmacy solutions. They are staying ahead of the curve to help employers put the pieces together to develop comprehensive strategies that manage healthcare dollars effectively, while empowering organizations with innovative solutions for a healthier future.