Anti-obesity medications have been met with reluctance from payers and employee benefits consultants who often lack analogs or empirical data to estimate the cost impact of new therapies coverage. Health plans considering coverage of anti-obesity medications will need to assess and manage the potential costs of covering these new therapies in context of their overall obesity management strategy, including coverage of nutrition counseling, weight management, and bariatric surgery.
Discuss actuarial methodologies and existing data sources to develop critical assumptions for the evaluation of the potential cost of treating obesity as a disease, including the covering anti-obesity medications, including
patient uptake and its variation by BMI category
average number of scripts per patient per year
brand/generic mix in the anti-obesity therapeutic area
areas for potential cost offsets, such as glucagon-like peptide 1 (GLP-1) receptor agonist use for comorbid diabetes and the use of bariatric surgery