The effects of obesity continue to be severe, complicated, and costly

2023 Q3 Rx Newsletter

August 22, 2023

Obesity can cause risky health conditions to develop

Obesity is a disease characterized by an excessive amount of body fat and is often diagnosed by measuring one’s body mass index (BMI). BMI measures weight in relation to height. A BMI equal to or greater than 30 is an indicator of obesity.1 According to the Mayo Clinic, “there are genetic, behavioral, metabolic, and hormonal influences on body weight.” These influences can include an unhealthy diet, lack of sleep, age, medications, stress, minimal physical activity, and socioeconomic factors.2

Obesity can Cause or Worsen Other Health Conditions

Individuals with obesity are more likely to develop other serious health conditions, and pre-existing conditions can be exacerbated. A few examples are listed below.

  • Heart disease and/or strokes: Obesity increases the likelihood of developing high blood pressure and may affect cholesterol and triglyceride levels.2
  • Diabetes: Obesity can impact how the body processes insulin, which can lead to abnormal blood sugar levels.2
  • Cancer: Recent studies show that obesity in both men and women increases the risk of developing cancer of the esophagus, colon, rectum, gallbladder, kidney, and more.3

Treatment can be Elaborate and Expensive

The objective of treatment for obesity is to attain and maintain a healthy weight. Obesity is often treated with an array of lifestyle changes, which may be accompanied by medication or procedures. Providers commonly recommend a healthier diet and more exercise, along with therapy or counseling.4

More critical cases of obesity may require weight-loss medications, such as GLP-1 drugs like Ozempic and Wegovy. Wegovy and Mounjaro are two of the newer GLP-1 drugs and the most effective. Wegovy is showing a 16% reduction in weight from the patient’s baseline, while Mounjaro is showing a 21% reduction.5

These drugs can help people lose weight, but they are expensive, making employers hesitant to cover their costs. Employers are concerned about the expense of the medications, which can exceed $10,000 per year without insurance.6

Employer Insights and Concerns

According to a survey conducted by the International Foundation of Employee Benefit Plans, 22 percent of employers currently cover weight loss medications for their employees.7

Employers are also weighing the short-term costs of the drugs against their long-term potential savings. Weight loss drugs could lower costs in the long run if they improve an employee’s underlying health conditions like hypertension or diabetes.6

Private payers have been reluctant to cover the drugs for weight loss only. Currently, Medicare is barred from covering any weight loss drugs. Weight loss drug coverage could be an attractive benefit for employees in a competitive labor market.6

If you have questions about how obesity treatments may or may not affect your employees and your business, contact our pharmacy practice.

 

Sources:
  1. “Learn About Obesity – About Obesity (Causes and Classifications),” Obesity Action Coalition, accessed July 22, 2023, https://www.obesityaction.org/education-support/learn-about-obesity/causes/
  2. “Obesity – Symptoms and causes,” Mayo Clinic, accessed July 22, 2023, https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742
  3.  “Learn About Obesity – Related Conditions,” Obesity Action Coalition, accessed July 25, 2023, https://www.obesityaction.org/education-support/learn-about-obesity/related-conditions/
  4. “Obesity – Diagnosis and treatment,” Mayo Clinic, accessed July 25, 2023, https://www.mayoclinic.org/diseases-conditions/obesity/diagnosis-treatment/drc-20375749
  5. “Weight Loss Drug Cost and Impact,” Optum Rx, accessed July 25, 2023, https://www.optumrx.com/public/landing
  6. “Employees are asking for this: Will more employers cover weight loss drugs?” Becker’s Payer Issues, accessed July 25, 2023, https://www.beckerspayer.com/payer/employees-are-asking-for-this-will-more-employers-cover-weight-loss-drugs.html
  7. “Employers Covering Prescription Drugs for Weight Loss,” International Foundation of Employee Benefit Plans, accessed July 25, 2023, https://blog.ifebp.org/employers-covering-prescription-drugs-for-weight-loss/