If you are like most benefits leaders, you are wrestling with the question of whether to cover the new generation of GLP-1 drugs for weight loss, or just for diabetes.

Covering, not covering, and covering with precertification each have major drawbacks.  This posting explores those drawbacks…and offers a fourth option, where you can steer only the better candidates to those drugs, to strike the right balance between cost and coverage.

And you can join our joint webinar with US Preventive Medicine (Sept. 7th at noon EDT) by registering here.

Those of you who’ve been reading this blog for years recall the old days of the outcomes-based wellness fad – led by Bravo, Wellsteps and of course Interactive Health – where the “idea” was that if you paid people enough, they would lose weight.

The predictable thing happened: employees gained weight in order to get paid to lose it again. There was even a cottage industry of coaching employees on how to gain weight, with this satirical blog post being (presumably) accidentally clicked on more than 100,000 times by employees googling on “how to cheat in a corporate wellness program.” The “recommendations” in that blog post could harm employees.

Employees cheated on those wellness programs just to make (or avoid losing) $500 or $1000 in extra taxable income.  Imagine how much cheating there will be to get access to Wegovy (or Ozempic), a  $12,000+ value equivalent to maybe $16,000 in extra taxable income.

Further, it is much easier to cheat because you aren’t being paid to reach a goal weight, as in wellness. . If your BMI is 28, you need only gain ten pounds and, well, the indication for Wegovy is a BMI of 30…and you would qualify.