Evaluating Weight Loss Drugs as a Benefit: A Guide for Brokers

If you haven’t heard about Ozempic or Zepbound yet, it’s bound to hit your radar soon!  

But really, even Oprah has admitted to using Ozempic, an injection taken weekly, to lose weight. Many celebrities, business leaders, influencers, and more are privately or openly taking the medication.  

As these drugs grow in popularity, employers face an interesting challenge: should access to Ozempic or Zepbound, which can retail at over $1,000, be provided by your place of work?  

According to Healthline, 20% of Americans say yes when asked if they would change jobs to join an organization that sponsors Ozempic or Zepbound as a healthcare benefit. 67% of respondents claimed they would stay at a job or company they hate if it also provided Ozempic or Zepbound as benefits. Clearly, these benefits are important to the people you serve! 

As a benefits broker, one of your top concerns is providing benefits your employers want and need to improve retention and recruitment rates at their organizations. So let’s cover what these drugs are, the companies that produce them, and determine if providing access to these medications is worthwhile for you and your agency growth. 

Background: How Did Weight-Loss Drugs Like Ozempic and Zepbound Become So Popular?

The spotlight on weight-loss drugs intensified during the pandemic as celebrities and influencers showcased rapid weight loss. This led to a surge in interest, revealing that these drugs, originally intended for type 2 diabetes management, also promote significant weight loss.

Here’s a quick overview of the key players:

• Ozempic: Developed by Novo Nordisk, this drug was initially approved in 2017 for managing type 2 diabetes. Its weight-loss benefits were soon discovered, leading to the development of a higher-dose version called Wegovy for obesity treatment.
• Zepbound: Eli Lilly’s competitor to Ozempic, Zepbound, is also a higher-dose version of Mounjaro, aimed at weight loss. While Mounjaro may be covered by insurance due to its diabetes management indications, Zepbound’s coverage for weight loss is rare.

Should Employers Offer Weight Loss Drugs As a Benefit? 

According to the Center for Disease Control (CDC), 73% of adults aged 20 or older are overweight or obese. Products that aid in weight loss aren’t just popular—they are on backorder in many countries and smaller municipalities. Reports state that European nation Belgium is considering a ban on the anti-obesity versions of Ozempic and Mounjaro due to the scarcity created by the demand. Diabetics are struggling to fill prescriptions for the drugs due to their increasing popularity.

Scarcity is less of an issue in America, but the demand is even higher. However, many struggle to gain access to the drugs and are turning to their employers for help. That is because Wegovy and Zepbound are rarely covered by insurance, and these drugs are expensive.

As a benefits broker, you have an opportunity to guide your clients in providing employer-sponsored access to these weight loss alternatives, which can significantly reduce turnover and prove a competitive advantage when recruiting talent. Many of your clients' employees may be part of the nation’s 73%, and these medications can help them lead healthier, happier lives.

However, for small to midsized employers, providing Wegovy/Zepbound as a benefit to their workforce may be cost-prohibitive. The drugs retail at around $1,000, in some cases $1,400, for a month’s supply. That’s only four shots, which the prescribed person injects weekly.

So, considering the potential benefit of providing employer-sponsored access compared to the costs, what should you recommend to your clients?

One approach is to perform a cost analysis of the situation. How much money might your clients save on retention and recruitment costs by offering improved access to Wegovy or Zepbound? This analysis can help determine if the investment in these medications is justified by the potential savings and benefits.

As a benefits broker, you’re best positioned to dive into the issues your clients' organizations face and develop creative solutions. This may be one of them! By staying informed and considering the real-world benefits and challenges, you can help employers make the best decisions for their workforce and organizational goals.

Top Broker Considerations for Weight-Loss Drugs

1. Understanding the Cost Dynamics 

Anticipate that many private insurance plans do not cover weight-loss drugs, placing the financial responsibility on employers if they choose to offer these as a benefit. By creating a cost-benefit analysis that includes the expenses of providing these drugs versus potential savings from improved employee health and reduced turnover, brokers can help clients make informed decisions about incorporating these benefits.

2. Evaluating Long-Term Necessity

Recognize that weight-loss drugs require ongoing use to maintain effectiveness, necessitating a long-term investment from employers. It’s important to discuss the long-term commitment required for weight-loss drugs with clients and help them evaluate whether this benefit can be sustained over time. Comparing projections with potential benefits, such as improved employee health and reduced medical claims, will help clients understand the long-term implications of offering weight-loss drugs.

3. Negotiation Opportunities

Investigate options for negotiating drug prices or alternative coverage solutions with pharmaceutical companies or insurance carriers. If your clients do choose to offer weight-loss drugs as a benefit, you can help them effectively manage those expenses.

4. Designing Tailored Benefits Solutions

Consider the various approaches to incorporating weight-loss drugs into employee benefits and how these drugs fit within a broader benefits strategy. Work one-on-one with clients to develop customized benefits solutions that address their unique needs and goals. You cannot take a one-size-fits-all approach here! 

5. Ensuring Legal and Ethical Compliance

Any benefits offered, including weight-loss drugs, must comply with relevant regulations and ethical standards. Keep up-to-date with regulations regarding benefits offerings, including non-discrimination policies and coverage requirements. You can go the extra mile by providing your clients with clear recommendations to ensure that any weight-loss drug benefits are legally compliant and ethically sound.

6. Supporting Comprehensive Wellness Programs

Brokers should consider how these drugs fit into a broader employee health and well-being approach. Advise clients on integrating weight-loss drugs into a holistic wellness program that includes other health and wellness resources and recommend that clients develop a comprehensive wellness program that combines weight-loss drugs with additional resources like nutrition counseling, fitness programs, and mental health support. 

Real-World Insights from Experts

At the Weekdays with Bernie Conference 2024, Dr. Jessica Rhodes from Eli Lilly shared research on Zepbound’s effectiveness for weight loss. She raised critical questions for brokers:

• Is your organization treating obesity as a chronic disease?
• Are current workplace well-being programs addressing obesity effectively?
• How is obesity affecting healthcare costs and productivity?

Dr. Rhodes highlighted that while weight-loss drugs like Zepbound can complement existing wellness programs, they are not a substitute for comprehensive health strategies. If you want to hear directly from experts like Dr. Rhodes, watch for information on Weekdays with Bernie 2025 coming soon! 

Additional Resources: 

• Brokers’ Corner Podcast—watch and subscribe to the Brokers’ Corner podcast, which dives into the topics that affect your agency and industry and identifies strategies so you can protect and grow your book of business 
• BerniePortal Brokers’ Council—a council of benefits brokers from across the country that advises BerniePortal on industry concerns, trends, and the ways technology can best support their agency and employer groups 
• BerniePortal for Brokers—leveraging technology to increase your agency valuation and support your employer groups is easier than ever with BerniePortal’s software solution, built for brokers by brokers