4 Facts Employers Need to Know About New Weight Loss Drugs

September 26, 2023

By Kristine Klepper, Executive Partner, Chief Operating Officer, Employee Benefits Practice & Jill Ambrose, RN, Vice President Director Wellness & Population Health

Over the last year, weight loss drugs have skyrocketed in popularity.

Originally approved to help individuals with diabetes, usage of Wegovy, Saxenda, Mounjaro, and Ozempic is rising rapidly due to their appetite-suppressing effects that are helping a wide range of individuals manage their weight.

While these drugs have been FDA approved for several years, these injected medications have been prescribed much more widely in recent months with many individuals seeing significant results. In a 68-week study, patients taking Wegovy lost an average of 35 pounds, or about 15% of their body weight. Eighty three percent of adults in the study lost at least 5% of their body weight.

These drugs have become so popular that some areas are even facing shortages. Obesity can lead to serious health complications such as high blood pressure, high cholesterol, type 2 diabetes, heart disease, and more, and lowering a patient’s body mass index (BMI) could significantly increase their lifespan. However, the jury is still out on long-term effects of taking these medicines, and many have reported regaining the weight once they stop treatment.

There is still much to learn about these drugs and their impact on patient health and wellbeing. As experts in the employee benefits space, we see both the potential benefits and drawbacks of their rise in usage. For employee benefits professionals seeking to keep their plan members safe while managing costs, there are a few things they need to understand about these new drugs. As their usage, accessibility, and cost continue to take shape, here are four things these professionals need to know:

  1. There are few restrictions in how they’re prescribed.

Today, the FDA has authorized Wegovy and Saxenda drugs to be prescribed to any patient with Type 2 diabetes and individuals with a BMI of 30 or more. They’re also approved for adults who have a BMI of 27 or more and a weight-related condition, like high blood pressure or high cholesterol. Mounjaro and Ozempic aren’t approved for weight loss, but people taking them also tend to lose weight. With such lenient restrictions, a massive number of Americans today qualify for treatment. Additionally, any doctor can prescribe Wegovy, Saxenda, Mounjaro, or Ozempic, meaning the prescribing physician does not need to be a weight management expert. These guidelines, combined with the fact that any physician can write a prescription, have increased the accessibility of these drugs to patients seeking them out.

  1. We’re still learning about the side effects.

A significant portion of patients taking Wegovy, Saxenda, Mounjaro, or Ozempic have reported mild stomach issues like nausea, diarrhea, and vomiting. But some are also reporting more serious side effects like pancreatitis, gallbladder problems, low blood sugar, and faster heart rate. One individual recently filed a lawsuit against the manufacturers of Mounjaro and Ozempic for failing to warn of the risk of severe gastrointestinal events that could be caused by taking the medications. She alleges the drugs caused her to experience severe vomiting, stomach pain, and gastrointestinal burning that resulted in hospitalization on multiple occasions. Both Wegovy and Saxenda also carry warnings about the risk of developing thyroid C-cell tumors and these drugs are not recommended for anyone with a personal or family history of thyroid cancer. Many patients are still in the early days of taking these medications, and we’re still learning about what potential complications may emerge.

  1. These drugs are high cost.

These drugs are expensive, and using Wegovy, Saxenda, Mounjaro, or Ozempic without insurance can cost more than $15,000 per year. Today, insurance companies tend to cover these drugs when they’re prescribed to treat diabetes, but many are yet to begin covering the use of these medications for weight management purposes. This high cost affects the accessibility of these drugs considering many individuals may not be able to afford them, especially not over a long period of time.

  1. No studies have been performed showing long-term effects.

Considering these drugs are relatively new, studies are still in progress to identify long term side effects. As noted above, usage has been linked in some cases to serious health conditions such as pancreatitis, and it remains to be seen how prevalent this issue may be. While many are excited about the drugs’ potential to create a less obese population, we must first ensure that the costs do not outweigh the benefits. This is critical for plan members seeking out these medications to understand.

The CSB Advantage:
When it comes to using Wegovy, Saxenda, Mounjaro, or Ozempic for weight loss, we’re still in the early days. Many questions around their accessibility, price, effectiveness, and long-term impact remain, and we’re encouraging our employee benefits clients to do all they can to fully educate their members on these innovative new treatments. While many are touting them as a miracle weight loss drug, there are certain side effects and downsides. Until these questions are answered, it’s important to approach these drugs with caution.

In today’s age of emerging high-cost drugs, evolving population health trends and increasingly costly employee benefits programs, working with a typical employee benefits commodity broker is not enough. At Conner Strong & Buckelew, we add value to your organization by providing expertise and insight on benefits-related challenges. We dig deep, administering questionnaires and holding interactive sessions to truly understand your operations, financials, employees and their behaviors. That enables us to determine benefit appropriateness, cost-effectiveness and marketplace competitiveness.

We don’t stop there. We also hire professionals with deep experience across the health care industry. Yes, we have many health insurance experts on staff. But we also employ registered nurses who can assess situations through a clinical lens to spot trends and give advice in ways other brokers can’t.

As utilization of these weight loss drugs rise in usage, it is critical that organizations work with their benefits broker to control costs and educate their plan members on how to use them safely. If you have questions, don’t delay. Contact us immediately to protect your plan members and your bottom line.

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Employee Benefits, Pharmacy & PBM Management

Practice Leader

Kristine Klepper

Executive Partner, Chief Operating Officer, Employee Benefits Practice

Practice Leader

Jill Ambrose

Partner, Director, Population Health