US employers hire virtual providers as weight-loss drug gatekeepers

 U.S. employers facing surging costs from paying for Novo Nordisk’s Wegovy and similar obesity drugs are hiring virtual healthcare providers like Teladoc to implement weight-loss management programs, a dozen consultants, pharmacy benefit managers, analysts, and providers told Reuters.

These programs may require diet and exercise before granting access to the medicines, and in some cases will become employees' sole covered option for medications like Wegovy and Eli Lilly’s rival therapy Zepbound, which have list prices of more than $1,000 a month.

They could help companies cut costs by limiting employees to small networks of less expensive providers or by delaying prescriptions with lifestyle change mandates, one of the benefits consultants said.

Another consultant touted the benefits of such programs, saying diet and exercise regimens could lead to long-term improvements in patient health.

“Many (employers) were skeptical about the cost of these drugs at the beginning of the year, but that mindset has shifted. Employers and health plans are now increasingly more willing to cover them, with the right programs in place,” Teladoc executive Ananth Balasubramanian said in an interview.

More than a quarter of 152 employers surveyed by the Business Group on Health said they would use virtual providers to oversee obesity drug prescriptions next year.

Boeing, Hilton, and Fortune Brands are among companies that have signed up for or expanded deals with virtual healthcare providers, according to sources familiar with the matter.

Truist analyst Jailendra Singh forecast the market for virtual obesity drug management could reach $700 million in 2024 and grow to as much as $9 billion longer term, assuming providers charge around $30 per member, per month, and $50 for physician appointments.

Reuters reported in June that the popularity of obesity medicines had U.S. employers rethinking insurance coverage, but most only required special authorization or had stopped covering diabetes drugs off-label for weight loss.

https://finance.yahoo.com/news/focus-us-employers-hire-virtual-110000089.html