More U.S. employers cover GLP-1 weight loss | Wilnesh News

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Good morning! A growing number of U.S. employers are covering a popular class of weight-loss drugs called GLP-1, a poll established.

About one-third of employer health plans in the United States say they cover GLP-1 drugs, such as Novo NordiskOzempic and Wegovy, which target diabetes and weight loss respectively, are up 26% from last year.

GLP-1 drugs used for weight loss also grew as a share of employers’ overall annual medical claims spending, accounting for nearly 9% in 2024, compared with about 7% the year before.

That’s according to a survey released Thursday by the nonprofit organize, the International Employee Benefit Plan Foundation, includes more than 33,000 member companies or public institutions. The survey was conducted in May among nearly 300 U.S. employer health plans.

The increased coverage is a win for patients, who often struggle to afford these drugs’ high $1,000-a-month price without insurance and other rebates. This is particularly important for Novo Nordisk, the makers of these treatments, and Eli Lilly and Companythey are working to increase insurance coverage and overall patient access to the drug.

It’s worth noting that most employee health plans and other insurance companies don’t cover weight-loss drugs, including GLP-s like Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound. Medicare also does not pay for weight loss treatments unless they are approved and prescribed for other health conditions.

GLP-1s used to treat diabetes, such as Ozempic and Eli Lilly and Company’s Mounjaro, are often covered by insurance.

Weight loss and diabetes drugs are soaring in popularity in the United States, drawing growing investor interest because they can help people achieve significant weight loss over time. They suppress appetite and regulate blood sugar by mimicking one or more hormones produced in the gut.

About 57% of employer health plans said they only cover diabetes management medications, compared with 49% in 2023, the survey showed.

But a large majority, about 19%, said they were considering whether to cover weight loss.

“This new survey data shows that GLP-1 coverage for both weight loss and diabetes has increased over the past six months,” said Julie Stich, vice president of content at the International Foundation of Employee Benefit Plans, in a press release.

Stich said new regulatory approvals and clinical trials, as well as increasing demand for GLP-1 drugs in the United States, will help expand coverage.

For example, Novo Nordisk’s Wegovy is now approved in the U.S. to reduce the risk of serious heart complications.

Insurance industry experts previously told CNBC that the approval would not automatically translate into broad insurance coverage for the weight-loss drug. At least some plans will take notice of Wegovy’s new uses and begin evaluating whether to cover the treatment the next time their prescriptions are renewed, these experts said.

Novo Nordisk and Eli Lilly are also conducting a series of studies of their GLP-1 drugs in different patients. This includes those with chronic kidney disease, sleep apnea and certain fatty liver diseases.

But there’s no doubt these drugs can put a strain on any health plan’s budget.

The survey shows that approximately 85% of GLP-1 employers rely “heavily” on certain requirements aimed at controlling costs.

This includes certain eligibility rules, such as requiring employees to have a certain body mass index (BMI) to receive coverage. It also includes “step therapy,” requiring its members to try other less-costly drugs or weight-loss methods before using GLP-1.

Meanwhile, other insurance plans are scaling back coverage of weight-loss drugs. Blue Cross Blue Shield, Michigan’s largest insurance company, said it will Start eliminating coverage Different diet pills for next year.

While employer insurance coverage has improved, there’s a bigger problem at hand: Novo Nordisk and Eli Lilly have struggled to provide enough treatments to meet demand. This is another part of the GLP-1 story that we will continue to follow.

Please feel free to send Annika any tips, suggestions, story ideas and data: annikakim.constantino@nbcuni.com.

According to one firm, a quarter of all healthcare investment dollars go to companies using artificial intelligence, and AI deal activity in healthcare is growing twice as fast as AI deals in the tech industry as a whole. recent reports from Silicon Valley Bank, now a division of First Citizens Bank.

The report states that venture capital firms invested US$7.2 billion in healthcare artificial intelligence last year, and this number is expected to reach US$11.1 billion this year.

Administrative applications of artificial intelligence in healthcare attracted about 60% of funding, the report said. Paperwork such as paperwork is a major burden on the healthcare sector and contributes to physician burnout and staffing shortages.

A February survey by Athenahealth showed that more than 90% of physicians reported experiencing frequent burnout, with 64% citing heavy administrative workloads as the primary cause. Surveys show that physicians spend an average of 15 hours per week outside of normal working hours on administrative tasks.

In other words, administrative work is a big problem in the healthcare industry. SVB reports that it is of particular interest to venture capital firms because it typically faces less regulation than clinical decision support tools or patient-facing solutions.

While healthcare AI companies expect to raise more funding this year than last, SVB said access to high-quality data and enough computing power to train models could be barriers to adoption.

This is especially true for AI-driven patient diagnostic tools, which account for 52% of total investment in clinical solutions, the report said. As of now, there is a “huge gap” in accessing the necessary computing power and data to train models that can accurately diagnose patients.

“Companies that can access data, work with clinicians and hospitals to leverage patient data, and partner with large technology companies are better positioned to deploy AI at scale,” the report states.

Please feel free to send Ashley any tips, suggestions, story ideas, and data: ashley.capoot@nbcuni.com.