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* Includes multiemployer and single-employer plans Among plans that cover GLP-1s to treat obesity, these are some of the ways coverage is being offered: Integrate weight-loss medication coverage with complementary weight-management/nutritional-coaching services, using third-party specialists Narrow the eligibility of weight-loss medications to limited pharmacies within the broad pharmacy network Limit coverage for participants without comorbidities to higher body mass index levels (e.g., Class II Obesity) Create a weight-loss coverage tier with higher plan participant cost sharing (e.g., 25 percent copayment) Limit the duration of GLP-1 coverage (e.g., 24 months) Dispense the medication only through the plans on-site clinic pharmacy Strategies to prevent off-label abuse Some plans that limit coverage of GLP-1s to treat diabetes have adopted these strategies to prevent off-label use of the medication: Tighter prior authorization, such as checking for biometrics, glucose test strips and continuous monitoring devices Rules specifying that coverage will only be provided when certain types of physicians (e.g., endocrinologists, cardiologists) write the prescriptions In April, we surveyed more than 160 large group health plan clients

[DOI] [PubMed] [Google Scholar] 3.Food and Drug Administration

Dyslipidemia, depression, obesity, and hypertension were the most prevalent health conditions