State Employee Benefits committee weight loss drugs

Weight-loss drugs to be added to state insurance plans

Sam HautGovernment, Headlines

State Employee Benefits committee weight loss drugs

The State Employee Benefits Committee voted Monday to add weight loss drugs to state insurance plans.

Delaware will cover new weight loss medications for state employees.

The Delaware State Employee Benefit Committee unanimously approved a plan that would include the drugs as well part of a program that includes utilization management and behavior modification programs.

It was unclear when the move would take effect.

Adding the drugs to state employee and retiree health plans will cost an extra $1.8 million, as opposed to simply approving the use of the drugs, which would cost an extra $2.8 million, the committee was told Monday.

The drugs, under the brand names of Victoza, Saxenda, Ozempic, Rybelsus, Wegovy and Tirzepatide, have become a nationwide sensation. 

Many started as drugs to help diabetics lower their blood sugar, but were so effective and popular that they have been approved for weight loss alone.

The utilization management programs will require previous participation in a weight management program as well as use of a reduced calorie diet and exercise.

Obesity rates have increased in the US during the pandemic and more than 40% of adults in the U.S. are obese, the committee was told.

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At last month’s meeting, public commenters asked the state to approve the drugs. If not, some said, at least take them off the list of banned prescription drugs. That would allow people to negotiate with their insurers.

Several other states, including New York, New Jersey, Massachusetts, Rhode Island, Virginia, North Carolina, Georgia, currently provide coverage for weight loss medication, while Florida is undergoing a pilot program for medication.

A Blue Cross Blue Shield federal employee benefit program that includes coverage of weight loss medications went into effect at the beginning of this year.

State insurance officials showed the committee links to studies funded by drug manufacturer Novo Nordisk and said they thought the state needed more long term studies.

One of those studies showed that there was an average savings of $157.41 to $185.41 per member per month from people that lost between 5% and 20% of their total weight.

Another study showed the cost of obesity through disability, workers compensation and absenteeism, which showed a cost savings of $17,196 per year if someone went from a 40 or greater BMI to a normal weight.

In other action, the committee approved insurance premium increases in plan copays.

One would increase copay costs for various hospital visits to encourage people to use the most appropriate sites for programs. Another would increase the copay for certain medications.

The hospital increases include a $25 to $75 increase for outpatient surgery and a $5 to $25 increase for high-tech imaging.

The medication increases will add $2 to the cost of a 30-day supply of generic drugs, $4 for formulary drugs and $10 for non-formulary. The costs would be doubled for a 90-day supply. 


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