BCBS Michigan to drop weight loss drug coverage

Rylee Wilson – Wednesday, June 12th, 2024

Blue Cross Blue Shield of Michigan will no longer cover GLP-1 drugs to treat obesity beginning in January, Bloomberg reported June 12.

A spokesperson for Michigan’s largest insurer told the news outlet it will drop coverage of GLP-1 drugs for weight loss in fully insured, large group commercial plans. The change will affect nearly 10,000 members taking the drugs.

The spokesperson cited concerns over safety, effectiveness and cost as the reasons for the decision.

In March, BCBS Michigan reported its pharmaceutical costs increased by $1.8 billion in 2023, including a $350 million increase in GLP-1 drug costs.

GLP-1 medications can cost upward of $15,000 a year. Ozempic and several other GLP-1 drugs are approved to treat Type 2 diabetes, though they are prescribed off-label for weight loss. Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound are approved by the FDA for weight loss.

Research published by the Blue Cross Blue Shield Association in May found nearly 6 in 10 adults prescribed a GLP-1 drug for weight loss discontinued the drug before seeing any meaningful clinical benefits.

A spokesperson for Novo Nordisk told Bloomberg the company was “disappointed” in BCBS Michigan’s decision to discontinue coverage of the drugs. Around half of commercial insurers cover Wegovy, the spokesperson said.

Some employer-sponsored plans have moved to drop coverage of weight loss drugs. St. Louis-based Ascension and the University of Texas System in Austin have dropped coverage from their employee health plans. In November, Mayo Clinic imposed a lifetime limit of $20,000 for weight loss medication coverage for its employees.
BCBS Michigan’s large-group commercial plan covers around 800,000 people.

Source: https://www.beckerspayer.com/payer/bcbs-michigan-to-drop-weight-loss-drug-coverage