Without the right support to supplement GLP-1 medication benefit offerings like Ozempic and Wegovy, organizations are missing out on the potential of any weight loss solution they offer now or in the future.
Over 50% of employees want weight loss drugs covered through their benefits, according to data from medical billing company Tebra. However, fewer than 1 in 5 companies cover such drugs, according to a recent peer-reviewed journal in Health Affairs, with only 3% saying they are likely to do so in the next year. Much of that apprehension has to do with how expensive and unreliable the medication can be — both of which digital healthcare platform FlyteHealth aims to address with their obesity care program.
"There's a [growing] confusion and misunderstanding in the treatment of obesity," says Sloan Saunders, CEO of FlyteHealth. "Without a comprehensive understanding of what's contributing to a person's weight gain and barriers, [organizations] typically don't see great outcomes."
Read more: How are companies affording GLP-1 coverage?
Currently, it costs organizations between $900 to $1,500 per month per patient to cover these medications, depending on the drug used, according to an article from HR software solution GoCo. In addition, data from pharmacy benefits management platforms Prime Therapeutics and MagellanRx found that only 32% of insured patients remain on GLP-1 therapy after one year, and just 27% are adherent to prescribed dosing. This all leads to ballooning healthcare costs, medication waste and diminished long-term outcomes, making the decision to cover treatment options difficult for organizations.
Personalization is key
The best way to address employers' concerns is to improve employee utilization of weight loss benefits, according to Saunders, which means providing better support throughout the treatment process.
"Treating obesity is complex," Saunders says. "So we set out to use technology that allows everybody access to a clinically effective weight program tailored to each individual patient to not only create a more cost effective solution, but one that gets great outcomes."
FlyteHealth's digital program gives employees access to personalized therapy for obesity by using an AI algorithm that provides tailored treatment plans. The platform combines virtual care, medication and lifestyle coaching from board-certified obesity medicine physicians, nurse practitioners and dietitians. The onboarding process includes scheduling appointments for necessary lab work, comprehensive medical history and risk assessments. The program can also use data collected from employees' wearable devices like Apple watches and Fitbits.
Read more: Essential questions benefit leaders must ask about GLP-1 coverage
Despite being relatively new, FlyteHealth's program is proving to yield a lot of success. The platform conducted an analysis through management consulting company Millman of the results from the year-long pilot of the program at one of their biggest clients, the State of Connecticut. Among employees, the data found an 86% adherence rate among new GLP-1 users and saved the State of Connecticut up to $1.2 million in anti-obesity medication costs.
"It's easy to just cover a medical prescription from a clinician," Saunders says. "But different medications function differently, and without [understanding how they work] they can be made less effective. A comprehensive system is needed to get not only better outcomes, but better durability."
How can organizations see the same results
The first step is to identify where there is a need and a lack of support. Saunders encourages HR and benefit leaders to prioritize collecting data on the utilization of whatever weight management benefit they may have and combine it with company-wide surveys that focus on employee feedback. Then, leaders can partner with a third party program that meets the demands they've assessed from their workforce and most importantly, one that is transparent.
Read more: GLP-1s are evolving — how benefit managers can prepare
"You might have a program in place in this area but still have absolutely no clue how it's doing," Saunders says. "Our program signals to companies what type of medications we're prescribing, when we're changing them, and what we're saving them from a pharmacy and medical claims perspective."
The conversation around obesity care and the market for supporting benefits is developing rapidly, which is why it's imperative that organizations start thinking about and implementing these changes as soon as possible. Especially as use cases for these treatments become broader.
"It's going to get more complicated but it's also going to become more standardized," Saunders says. "What are organizations going to do when GLP-1s drugs can be used for other diseases? That is the future we're heading to and it will require a massive reframing of current healthcare offerings."
