Citing high costs and low medication adherence, self-insured employers nationwide are making moves to end or limit coverage for employees prescribed weight loss medications, including major health systems.
Six health systems that have recently ended or limited coverage for weight loss drugs:
RWJBarnabas Health ended coverage for GLP-1s when prescribed for weight loss. The policy was effective Feb. 1 and does not affect employees prescribed GLP-1s for diabetes management. The West Orange, N.J.-based system cited a lack of sustained adherence to the medications.
Fairview Health Services limited coverage of Wegovy and Saxenda to employees with a body mass index of 40 or higher, beginning in 2024. The Minneapolis-based system said it anticipated $10 million in annual cost for the two drugs without the new policy.
HealthPartners told Becker's the Bloomington, Minn.-based organization will limit employee coverage for weight loss medications such as Wegovy but did not elaborate on what the restrictions will entail.
Mayo Clinic limited coverage for weight loss drugs through its employee health plan by imposing a lifetime limit of $20,000 for weight loss medication coverage. The Rochester, Minn-based system said the coverage limit does not apply to GLP-1s prescribed to employees for diabetes.
Ascension dropped coverage for weight loss drugs for its 139,000 employees in July. The St. Louis-based system said the move came after a review of the "safety, long-term outcomes, national coverage benchmarks, and cost-effectiveness" of weight-loss and anti-obesity prescription drugs.
Hennepin Healthcare ended coverage for Wegovy and other injectable weight loss drugs. The Minneapolis-based system cited high costs and questions around employee adherence to the medications.