Wednesday, Sep 13, 2023

Worried About the Cost of Weight-Loss Medications? Here is What Employers Need to Know

Scott PaddockCEO, Wondr Health


The cost of weight-loss medications is downright tricky. Wondr Health Chief Executive Officer Scott Paddock shares what employers need to know to stay ahead of the curve in achieving long-term clinical outcomes and cost savings. 

As CEO, employee health is a top priority. It is critical to leading a high-performing organization and managing healthcare costs. This perspective helps me understand the unique challenge employers face when it comes to covering new and costly weight-loss medications to treat obesity. 

With the demand for newer GLP-1 medications such as Wegovy, Ozempic, and (soon) Mounjaro soaring, the potential cost fallout has become an increasing concern for both self-insured employers and health plans. Many organizations are facing a critical decision right now: to foot or not to foot the weight-loss medication bill. 

So, what is the best way to simultaneously offer treatment for obesity and obesity-related diseases and responsibly manage the economic burden? Rather than excluding weight-loss medications entirely, a strategic plan design can offer the best of both worlds. With the following guidelines and expert guidance from a proven partner, organizations can implement a cost-effective and clinically impactful obesity management benefit:

  1. Require engagement in a comprehensive behavior change program to drive sustainable outcomes: While GLP-s are game changers, they do not address underlying behaviors, which often are the root cause of weight gain, and anyone who discontinues a weight-loss medication without additional support is likely to regain weight. Adding a comprehensive behavioral change program can lead to sustained weight loss, improved physical health, and increased quality of life. Requiring participant engagement for prescription refills also ensures patient safety. 
  2. Employ a rigorous clinical management model & trusted prescribing partner to promote better outcomes & contain costs:
  • Develop an open formulary for tailored prescribing: There are many affordable weight-loss medications outside of GLP-1s that have been around for years. It is important to leverage the full range of weight-loss medications, not just GLP-1s, to ensure individuals get the right treatment based on their unique needs. Not using the full-spectrum of weight-loss medications can be both clinically detrimental and unnecessarily costly. 
    • Consider a step-therapy approach: There is no "one-size-fits-all" approach to weight-loss medication, and GLP-1s shouldn’t necessarily be the first resort. Consider using GLP-1s only when other medication protocols have failed and prescribe the most cost- and clinically effective drug, considering the patient’s whole health.
    • Evaluate eligibility criteria: Even outside of the strict criteria that individuals must meet to be considered eligible for a prescription, GLP-1s aren’t the right choice for everyone. Consider offering this class of drugs only to the most acute participants in your population. When prescribing weight-loss medication, a provider also should consider co-morbidities, contraindications, drug indications, and more affordable alternatives to ensure optimal results for every patient.

3. Leverage reporting and tracking to ensure impact and results: Ongoing monitoring helps manage patient safety and tracks positive health outcomes like weight loss over time, engagement with the behavior change program, clinical and medication adherence, and improvements in musculoskeletal pain, stress, and sleep. 

In this new frontier of obesity treatment, weight-loss medications can make a meaningful difference in managing obesity and its related health concerns and costs. By using these guidelines, organizations can reduce the potential costs of weight-loss medications while also improving the health and lives of their people. 

For a closer look into leveraging a successful obesity management program, download the Obesity Management Program Best Practices Guide for employers. 

Learn more about our solution, Wondr Advanced, the advanced obesity solution to help organizations navigate the complexities of weight-loss medications to optimize outcomes and control costs. 

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