New Survey Data Reveals Total Reported Annual Claim Representation for GLP-1 Drugs for Weight Loss Has Increased to Almost Nine Percent
A new survey report from the International Foundation of Employee Benefit Plans reveals updated U.S. employer coverage surrounding glucagon-like peptide-1 (GLP-1) drugs. The International Foundation first conducted this survey in October 2023. Considering the growing prominence of this category of pharmaceuticals, a new pulse survey on GLP-1 drugs was deployed in May 2024.
Employers indicated the following coverage for GLP-1 drugs:
- 57% provide coverage for diabetes only (up from 49% in 2023)
- 34% provide coverage for both diabetes and weight loss (up from 26% in 2023).
Of those that currently only offer GLP-1 coverage for diabetes, 19% are considering offering the drugs for weight loss.
Employers indicated that 8.9% is the average representation of GLP-1 drugs used for weight loss in total annual claims for their organization, an increase over the 2023 average of 6.9%.
Those employers covering GLP-1 drugs rely heavily on utilization management (85%) to control costs. These techniques include prior authorization and BMI and/or comorbidity requirements. Less common cost-management approaches include step therapy (18%) and eligibility requirements (16%). Nine percent of employers have no cost-control mechanism in place.
This new survey data shows that in the last six months, GLP-1 coverage has increased for both weight loss and diabetes. When I spoke with Julie Stich, CEBS, Vice President of Content at the International Foundation, she said that with the release of new FDA approvals and clinical studies, and increasing demand and awareness, employers are seriously considering how to proceed with drug coverage policies in response.
The most prevalent factors employers are taking into consideration for GLP-1 drug coverage for obesity care include:
- 76%—Obesity as a risk factor for chronic conditions and associated costs
- 71%—Broker/consultant/PBM recommendations
- 62%—Impact/effectiveness of cost-control mechanisms
- 57%—GLP-1 label expansion
- 56%—Long-term costs
- 39%—Lack of clinical studies for long-term use of GLP-1 drugs.
Responses are reflective of 279 employers surveyed between May 22 and May 29, 2024. Visit www.ifebp.org/GLP1drug2024 for more information and to view the full survey report.
