With the recent increase in demands for new drugs like Wegovy and Ozempic, 43% of employers are now considering covering GLP-1s next year, nearly double today’s number. Since its first FDA approval in 2005, GLP-1s have proven effective for health conditions like obesity and diabetes.

However, with a steep price tag and concerns about misusage, leaders may find adding GLP-1s to their benefits offerings to be challenging. In a recent From Day One webinar, physicians from Accolade joined moderator Katie Miller Blakemore, senior manager of events at Accolade, to discuss the trends around GLP-1s.

Understanding Cost Benefits

On average, medication like Ozempic can cost more than $1,000 per month, a deterrent for some leaders considering proving it in their benefits. However, there may be greater healthcare costs if employers choose not to offer these drugs, says James Wantuck, MD, associate chief medical officer at Accolade and co-founder of Plush.

“There are two sides to this equation: the cost of the drugs and the cost of not using the drugs,” Wantuck said. “Employers need to consider the costs for not using the drugs which may include things like absence from work or inability to do as much at work.”

Wantuck points to the cost of obesity as one example. Chronic diseases caused by obesity and excess weight cost 1.72 trillion dollars in the U.S. alone in 2016.

With a direct effect on one’s cardiovascular system, GLP-1s can reduce the severity of these diseases by reducing the chances of heart failure and strokes. Having healthier employees is an invaluable asset to any company, Wantuck said. “It’s harder to dismiss and not cover a drug that prevents a heart attack,” Wantuck said. “The price decreases as employees get less sick.”

In comparison to similar countries, GLP-1s cost five to ten times more in the U.S. and the prices are not expected to change anytime soon, says Connie Hwang, MD, Accolade’s chief medical officer.

“The FDA approved GLP-1s almost two decades ago, and yet there are no generic competitors in this class of drugs,” Hwang said. “The patents and regulatory exclusivity granted show a median of 18.3 years of market protection and so putting this into perspective, the earliest date for a possible generic Ozempic is guaranteed for December 2031. Employers need a GLP-1s strategy now as there is likely no pricing relief in sight.”

Giving Access to the Right People

Not everybody qualifies for GLP-1s but high costs and the spike in popularity of some drugs from mainstream media have caused employers to enforce restrictions and in some cases, outright bans.

Qualifying for GLP-1s states individuals need to have a BMI greater than 30 along with medical problems such as hypertension, type two diabetes, or cardiovascular disease.

“Some large employers have eliminated coverage for GLP-1s for the weight loss indication, and many have done so pointing to the greater than 200% total cost increases that they’ve been seeing,” Hwang said.

Eliminating GLP-1 options negatively affects people who need the medications, bringing the strategy back to the need for employers to evaluate cost benefits. In a study of how members receiving GLP-1s meet the protocol criteria, researchers discovered that 94% of Accolade Care members did meet the criteria.

Offering GLP-1s is only the beginning of the journey for employers, Wantuck says. Employers need to provide employees with resources to continue the momentum of their lifestyle change for a successful exit from these drugs.

“You have to be open to a lifestyle change to change your habits, diet, and exercise routine to make these drugs the most effective that they can be,” Wantuck said. “These drugs facilitate this weight loss and allow people to reach the goals they’ve never been able to reach before, and I think that inspires them to change their habits.”

Editor’s note: From Day One thanks our partner, Accolade, for sponsoring this webinar.

Wanly Chen is a writer and poet based in New York City.