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Coverage for Obesity Drugs
While there is inconsistent insurance plan coverage for these drugs, weight-loss medications are likely to hit drug formularies and pharmacy benefit plans in the next year as health plan sponsors are pressured to cover and grapple with this staggering expense.
Jennifer Perlitch, RPh, assistant vice president, Pharmacy, Spring Group, shares this perspective, “Yes, these drugs have created a lot of buzz among our employer client base. There are various factors for employers to consider when evaluating adding weight loss drug coverage into their plan, as they are not typically covered.”
She says that it is important to note that Ozempic and Mounjaro are not currently approved to treat weight loss, only type 2 diabetes, adding, “Despite the approved indications, Ozempic appears to have high utilization for weight management in people without diabetes, hence the “Hollywood Diet” term, something employers should keep
