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Weight-loss drug coverage rises among largest US employers, Mercer survey finds

by November 20, 2024
written by November 20, 2024

(Corrects paragraph 9 to remove reference to self-insured plans; paragraph 13 to show it is a specific type of health plan; last paragraph to show survey included employers of 50 people or more)

By Amina Niasse

NEW YORK (Reuters) -About 44% of U.S. employers with 500 or more employees cover drugs for weight loss in 2024, up from 41% in 2023, according to a survey from consulting firm Mercer (NASDAQ:MERC) released on Wednesday.

Mercer also said 64% of U.S. employers with over 20,000 employees covered weight-loss drugs in 2024, compared with 56% last year.

That includes the highly effective newer GLP-1 drugs Wegovy from Novo Nordisk (NYSE:NVO) and Eli Lilly (NYSE:LLY)’s Zepbound that have been shown in trials to reduce weight by 15% to 20%, as well as older drugs in the class that promote less weight loss, such as Novo’s Saxenda.

Obesity drugs have driven costs up for employers this year and contributed to an increase in overall healthcare benefit costs, the survey found, resulting in changes to how patients access the drugs.

“Cost is clearly a concern, and employers are adding authorization requirements to ensure the medications are used by members who will benefit the most,” said Tracy Watts, Mercer’s national leader for U.S. health policy.

Those include clinical coordination, or management of patient care by pharmacy benefit managers and insurers, the report said.

Only about 24.4 million Americans have access to GLP-1 drugs through commercial health plans, Reuters reported on Monday. Mercer’s survey question referred to weight-loss drugs from any class of medicines.

Companies with over 500 employees also increased fertility treatment coverage, with 47% paying for in vitro fertilization, in which an egg is fertilized outside of the uterus, up from 45% in 2023.

For all employer health plans, the annual cost for a single employee rose 5% from 2023 to $16,501.

A Mercer report released in September found that employers had expected a 5.8% increase in health insurance costs, even after implementing cost-reduction measures.

To try to lower costs, employers have expanded health plan options and focused on those that have metrics comparing patient outcomes against costs, the report said.

About 65% of large employers offered three or more health plan choices in 2024. Employers with over 20,000 employees offered an average of five medical plans, Mercer said.

Nearly one-third of large employers offered an Exclusive Provider Organization health plan that limits patients to providers within its network. One-third of those plans do not require a deductible.

About 87% of Americans were enrolled in a health plan with a deductible in 2024, according to a KFF survey.

Mercer’s survey covers 2,194 U.S. employers ranging from those with 50 to over 20,000 employees.

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