US is only country debating GLP-1 insurance coverage for weight loss: Cigna CEO Cordani
Cigna (CI) CEO David Cordani is not convinced of the benefits of GLP-1s for weight-loss patients and said the US is the only country among developed nations where insurance coverage is being debated.
“We’re the only country … that [is having] this debate around covering [them] for weight management. If individuals in other countries want it for weight management, that’s an out-of-pocket individual decision,” Cordani said.
He spoke at the Economic Club of D.C. Wednesday, discussing a number of issues, including GLP-1 benefits and coverage.
“About 50% of large employers have chosen to cover it for weight management. As you go down, a smaller percentage of small employers do,” Cordani said.
“We would make more money if 100% of our employers covered 100% of their employees for GLP-1s,” he added.
But the company is worried about the unintended consequences of encouraging coverage of weight-loss drugs, including Eli Lilly’s (LLY) Zepbound and Novo Nordisk’s (NVO) Wegovy. The other GLP-1s are intended for diabetics and are covered 100%.
Cigna, along with all other major insurers CVS (CVS) and UnitedHealthcare (UNH), also offers a weight-management program to help patients stay on course and benefit the most from the drugs’ potential.
Often, side effects are cited as a reason why patients stop taking the drug for weight loss, and some are only on it for short-term goals. This has resulted in unintended consequences that are costly.
“There’s up to 50% of individuals who go on to GLP-1 for weight management who stop taking the drug within 12 to 14 months for a variety of reasons, side effects — gastrointestinal, behavioral, or otherwise. That’s a bad outcome,” Cordani said.
Telehealth companies have also offered support services for GLP-1 users, such as Omada and Included Health. The latter recently told Yahoo Finance that clients have shared that medical spending is skyrocketing from emergency room visits for digestive issues from GLP-1 users.
In addition, 20% of one client’s total pharmacy spend is now on GLP-1s, double what it was last year, Included Health said. The company said 30% of its clients are Fortune 100 companies.
It’s why, Cordani said, the weight management benefit is not currently worth the cost.
Cardani said drug-induced weight loss also comes with a drop in muscle mass and that patients who go off the drug tend to regain fat, though not muscle mass.
“The person 14 months later is less healthy than they were when they started the drug,” Cordani said.
