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March 22, 2024

Managing health care costs with the rise of GLP-1 medications

Russell Millison, Rick Kelly

In today's health care sector, mid-market companies face pivotal decisions - particularly those pioneering self-funded health plans. Central to their challenges is the surge in expenditures on GLP-1 medications like Ozempic, Mounjaro, and Wegovy. These treatments, pivotal in the fight against diabetes and obesity, come with a significant cost—some around $17,000 per patient yearly. Innovations are on the horizon, such as exploring GLP-1s for additional conditions like cardiovascular disease and more patient-friendly oral versions, yet this progress also means rising expenses. With projections indicating GLP-1 spending could reach $18.2 billion by 2027, this scenario significantly escalates pharmacy costs already outpacing inflation and broader medical trends.

Marsh McLennan Agency's Self-funding, Simplified™ program is a beacon of control and customization in this challenging environment. It enables employers to tailor their pharmacy benefits, employee benefits, and wellness offerings to meet the unique health needs of their workforce and adapt to the evolving health care landscape. Despite the proven benefits of GLP-1s for weight management, and with a significant portion of patients seeking these medications, coverage remains limited. Currently, 33% of employers offer GLP-1 coverage for weight management, which is predicted to increase in 2024, with those already offering coverage reporting a 75% increase in employee satisfaction and well-being. This discrepancy highlights the necessity for long-term GLP-1 treatment to sustain weight loss, which will, in turn, drive up health care spending.

The Marsh McLennan Agency Rx Solutions team offers hope with their proactive and strategic approach. Through in-depth analytics from an actuarial and clinical perspective, the pharmacy practice is deeply involved in identifying and evaluating comprehensive approaches beyond "sound bite" solutions. Their goal is to guide employers through this intricate landscape, making financially prudent and morally sound choices with a strong emphasis on the health and well-being of employees. This collaboration with Marsh McLennan Agency is more than just a cost-management strategy; it represents a dedication to innovation, flexibility, and a relentless commitment to improving health outcomes for all stakeholders.

To learn more about how to approach these weight loss drugs, watch the recording of our webinar panel discussion around the pros and cons of GLP-1s from an employer perspective and best practices for adding them to your formulary.