Minnesota system latest to drop weight loss drug coverage for employees 

Minneapolis-based Hennepin Healthcare is ending coverage for Wegovy and other injectable weight loss drugs from its employee health insurance plan next year, the Star Tribune reported Oct. 20.

According to the report, Hennepin Healthcare's decision stemmed from a $120 million budget shortfall the system is facing in 2024 and a 20% increase in costs for its health plan administered by Medica.

"We spent like $7 million on one drug, and that's a lot," David Hilden, MD, chair of the health system's medical department, told the Star Tribune.

Dr. Hilden told the publication the decision also stemmed from questions around employee adherence to the drugs. He noted that employees taking weight loss drugs are at risk of putting weight back on if they end their regimen.

As demand for GLP-1s such as Ozempic and Wegovy continues to surge, payers and self-insured employers have consistently ended coverage for the weight loss medications over the last year. St. Louis-based Ascension dropped coverage for weight loss drugs from its employee health plan in July, and the University of Texas System in Austin ended coverage under its employee and retiree health plans in September, 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. Private insurers often do not cover GLP-1 drugs for weight loss only, though they have been more likely to cover the drugs when they are prescribed to treat diabetes. Ozempic, Trulicity, Victoza and Mounjaro are FDA approved to treat Type 2 diabetes, and Wegovy and Saxenda are approved for weight loss. 

The country's largest insurer, UnitedHealth Group, told investors in October it wants to lower the price of weight loss drugs, but it needs drug manufacturers such as Novo Nordisk (Ozempic, Wegovy) and Eli Lilly (Mounjaro, Trulicity) to get on board. 

"We're very positive about the potential for another tool in the toolbox to help folks manage their weight," CEO Andrew Witty said. "We recognize that has potential benefits, but we're struggling, and frankly our clients are struggling, with the list prices which have been demanded of these products in the U.S., which are running at about 10 times the level of prices paid in Western Europe." 

"We need the manufacturers to move. It's as simple as that. And we remain extremely open minded to any model that works," Mr. Witty added.

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