Mayo Clinic moves to limit weight loss drug coverage for employees

Mayo Clinic will limit coverage for weight loss drugs through its employee health plan starting in 2024, the Post Bulletin reported Nov. 11. 

The Mayo Medical Plan, administered by Medica, will impose a new lifetime limit of $20,000 for weight loss medication coverage. The coverage limit does not apply to GLP-1s prescribed to employees for diabetes, such as Ozempic.

"Mayo Clinic continuously and carefully assesses our prescription coverage and annually makes adjustments that balance affordability and coverage, in the best interests of our plan members," a Mayo spokesperson told the Post Bulletin. "Plan members are encouraged to talk with their provider(s), who are able to help determine safe and effective care treatment options and plans."

Rochester, Minn.-based Mayo joins other health systems that have moved away from weight loss drug coverage for employees this year. 

Minneapolis-based Hennepin Healthcare is ending coverage for Wegovy and other injectable weight loss drugs from its employee plan next year, which is administered by Medica. Hennepin cited high costs and questions around employee adherence to the medications.

St. Louis-based Ascension dropped coverage for weight loss drugs from its employee plan in July, and the University of Texas System in Austin ended coverage under its employee and retiree health plans in September, also citing high costs and low adherence rates.

According to data shared with Becker's by weight management platform Found, 69 percent of patients in a national sample did not have insurance coverage as of June for GLP-1s for anti-obesity or diabetes, a 50 percent decline in coverage since December 2022.

Other recent research on GLP-1 coverage trends has varied. A September survey of large employers found 26% plan to offer weight loss drug coverage in the next year, while an October survey of HR leaders at large companies found 43% plan to cover GLP-1s in 2024.

GLP-1s come with a steep price tag, costing upward of $10,000 per year without insurance. Ozempic, Trulicity, Victoza and Mounjaro are FDA approved to treat Type 2 diabetes, and Wegovy and Saxenda are approved for weight loss.

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