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What’s happening:  Demand for weight loss drugs have soared over the last year, to the point that semaglutide -- better known by the brand names Ozempic and Wegovy -- are beginning to cost U.S. employers and employees millions of dollars more than anticipated.

The challenge: The drug’s rising popularity due to social media and celebrity buzz is pushing employers to revisit their healthcare policies and, in many cases, add extra requirements to qualify for approval.

Today, the top non-specialty drug therapeutic categories that drive employer costs are diabetes, HIV, and stroke/blood clot prevention. Weight loss drug spending is now fourth and on the rise. Statistics demonstrating the increase in obesity drug treatment costs for Aon’s national pharmacy practice clients include:

• The average monthly cost is approximately $1,330 before rebates.
• The 2023 cost and utilization for obesity treatment are on track to at least double from 2022.
• The total spend for Wegovy alone in February 2023 was greater than all Q4 2022.

Aon experts weigh in:

• Some employers are requiring participation in a structured weight-loss program to obtain Ozempic or Wegovy approval or trying other weight loss drugs and treatments first. According to Tracy Spencer, national pharmacy practice leader at Aon, “Employers are looking for guardrails to be sure the drugs are used appropriately.” Read more in The Wall Street Journal, "Your Company Doesn’t Want You to Take Ozempic for Weight Loss. Here’s Why.”
• “Employers that cover weight-loss drugs have required medical practices to document patients’ need for Wegovy since it was approved. Increasingly, they are introducing additional eligibility requirements,” said Aon Consultant Michael Manolakis. Read more in Reuters , “Obesity drug Wegovy’s popularity has US employers rethinking insurance coverage.”
• Aon has seen a 165 percent quarter-over-quarter increase in Q1 for weight-loss therapy costs in employer health plans, and the total spent for Wegovy in February 2023 was greater than all of Q4 2022.
  • Tracy Spencer, national pharmacy practice leader at Aon, said “Employer plan sponsors are contemplating their options, where this is not simply a cost avoidance situation for them. The conversations that they’re having are to make sure that the investment they are making will have the long-term impact that they’re hoping for.” Read more in Fortune, “Ozempic isn’t alone. A whole class of ‘revolutionary’ weight-loss drugs is on the market—but only for the wealthy.”

Aon’s Global Medical Trend Rates Report 2023 shares expert insights on expectations for future medical trend rates, based on interactions with clients and carriers. Check it out here and in Treasury and Risk.