December 13th 2023.
U.S. employers are turning to virtual healthcare providers like Teladoc to implement weight-loss management programs, in order to reduce costs associated with obesity drugs like Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound. These drugs have list prices of over $1,000 per month, making them a financial burden for employers. The programs will require employees to adhere to diet and exercise regimens in order to be granted access to the medicines.
According to a survey by the Business Group on Health, more than a quarter of employers will be using virtual providers to manage obesity drug prescriptions in the coming year. Companies such as Boeing, Hilton, and Fortune Brands have already signed up for or expanded deals with virtual healthcare providers. Industry analysts predict that this market could reach $700 million in 2024 and up to $9 billion in the long term.
In order to manage the use of these drugs, Aon proposed a “step therapy” program in August. This program suggests that patients must go through at least one to three months of lifestyle changes, such as diet and exercise regimens, before they are prescribed the drugs. This would help them form healthier habits and provide coaching and other support.
Blue Cross Blue Shield of Michigan announced that it will offer employers an option to sign up for Teladoc’s weight management program, which includes six months of diet and exercise. Patients must continue these habits in order to keep being prescribed the drugs. Companies are also setting up “centers of excellence” for weight loss, with virtual providers overseeing the program.
The American Medical Association President Jesse Ehrenfeld noted the potential danger of replacing in-person care with telehealth. He said telehealth should be used as a supplement to, not a replacement for, in-person provider networks.
Companies are hoping that by setting up these programs, they can spread the cost of the drugs or avoid paying for them entirely. Jeff Levin Scherz at benefits consultant Willis Towers Watson said that step therapy will delay eligibility and by the time people are eligible, they might no longer be on the plan.
Overall, virtual healthcare providers may prove to be an effective way to manage the cost of obesity drugs while helping employees improve their health in the long term. Employers must be aware of the potential dangers of over-reliance on telehealth and the need to maintain continuity of care.
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