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How your myHSA Plan can Help Grapple with Weight Loss Drugs in your Benefit Plan

The drug landscape in 2023-24 is becoming more complex than ever, with weight loss drugs like Ozempic driving unprecedented demand. New block-buster drugs are coming, so addressing how these medications are treated in your benefits plan is more important than ever.

The drug landscape in 2023-24 is becoming more complex than ever. A significant drug trend is the demand for Ozempic and new other GLP-1 Agonist therapies that are being used for weight loss. Popularized by social media and celebrity endorsements, this drug represented one quarter of drug spend in 2023.

Traditionally, weight loss medications have been considered lifestyle medications, and coverage is largely excluded or has low lifetime limits applied within an insured benefits context. But statistics around obesity and the comorbid health consequences are bringing to light how this complex health issue might be better addressed by health plans.

Ozempic and newer therapies such as Wegovy cost around $7,000 - $10,000 per year and need to be taken for life for most patients in order to sustain the weight loss achieved by your employee or their dependent. Covering the entire cost of these therapies as part of an employee's total compensation would be difficult for many organizations.

Supporting weight loss programs -- including fitness programs, weight loss tools such as nutrition support through Health Spending Account and/or Wellness Spending Accounts gives plan members the flexibility to invest in what matters most to them.

Spending accounts also offer several added benefits to both plan sponsors and plan members:

  • The weight loss drug pipeline is already delivering medications that are easier to administer or require fewer injections. While Ozempic was never approved for weight loss, new medications will be. Health Spending Accounts offer reimbursement for these drugs without a need for prior authorization by an insurance company.

  • Demonstrating your commitment to employees' overall wellbeing -- including supporting weight loss goals -- can have a positive impact on your culture and employees' overall sense of job satisfaction.

Even if your health spending account allowance is not enough to cover 100% of the weight loss drug, you’ve demonstrated a commitment to your team’s well-being.

Reach out to us today to discuss your plan and changes that you could consider.


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