Chronic weight management medication benefits for the workplace
Over the last year, the trend and discussions surrounding weight loss drugs and solutions has skyrocketed. The market for these medications exploded onto the scene, with many individuals inquiring about coverage and use.
Weight loss medications such as Wegovy contain an active ingredient called semaglutide and has been approved by Health Canada as a treatment for chronic weight management. Another drug on the market containing semaglutide is Ozempic, however, it has only been approved for the treatment of type II diabetes. While there are cases where Ozempic is prescribed for weight loss by doctors, this is considered “off label use”, meaning it will not be covered by many benefit providers.
Why should employers consider chronic weight management medications for employee benefits?
Obesity is a chronic disease that one in four Canadians experience.[1] Many individuals who suffer from the disease also experience other health issues, like diabetes, mental health problems and high blood pressure. Studies show that a key factor in weight gain is our genetics, with up to 70% of a person’s BMI being predetermined by their genetics. Research also shows that only one in five individuals living with obesity can reduce 10 per cent of their body weight through diet and exercise alone.[3]
By recognizing that obesity and weight-loss solutions aren’t a one-size-fits all solution, employers can help encourage employees with evidence-based resources and medications by offering benefits that improve their whole health and wellness.
The Canadian Adult Obesity Clinic Practice Guidelines[4] recommends resources like medical nutrition therapy, exercise accommodations, psychologic support and, where appropriate, medications for weight loss and maintenance, including bariatric surgery. The average monthly cost of weight management solutions per 1,000 covered lives is estimated to be less than $10 per covered life annually. [5]
What solutions does Saskatchewan Blue Cross offer?
As a leader in whole health and wellness, Saskatchewan Blue Cross can assist employers with chronic weight management benefits such as enhanced coverage, including EFAP resources, Personal Wellness Accounts and weight-loss medication coverage (special authorization required).
Effective June 1, 2024, Wegovy will be covered by group benefits plans with Special Authorization requirements. Members will be required to fill out a Chronic Weight Management Prescription Drug Special Authorization Form to request approval for coverage.
In addition to Wegovy, Special Authorization criteria will be introduced for three existing weight management drugs covered under our drug benefit lists: Xenical, Contrave and Saxenda. Any new requests for these drugs will need to fill out a Special Authorization form. These drugs should be prescribed in addition to a reduced calorie diet and increased physical activity. Specific BMI values and related medical conditions will also be reviewed before approval for coverage.
Learn more about plans and solutions for your employees today, visit sk.bluecross.ca/workplace-benefits.
References
[1] Obesity Statistics in Canada for 2024 | Made in CA
[2]https://www.sciencedaily.com/
[3] https://www.benefitsandpensionsmonitor.com/benefits/
[4] Canadian Adult Obesity Clinical Practice Guidelines – Obesity Canada
[5] https://www.benefitsandpensionsmonitor.com/