| Dan Eisner, Advisor, ZLC Employee Benefits Solutions |
There is a good chance that you have heard something about the brand name drug, Ozempic, and have wondered what the fuss is all about. You may already be running into this drug on your employee benefits plan and wondering how it fits into a group benefits program. More likely, you might have seen ads on TV with actors asking questions about the drug without explicitly saying what the drug is or what it treats. It’s also the latest drug to go viral from exposure from the many TikTok personalities in or celebrities promoting their rapid weight loss using Ozempic. It all begs the question of “what’s up with Ozempic?”.
To better explain, let’s first debunk a couple of myths:
• While much of the discussion around this relatively new drug is about rapid weight loss, Ozempic was developed primarily for people with Type 2 Diabetes.
• Now that it has been in use for a little while, many individuals with Diabetes on the drug also noticed weight loss. That said, while some people are actually taking Ozempic for weight loss, even though they do not have Diabetes, they are often paying out of their own pocket as most employee benefits plans in Canada do not cover this drug for anything other than Diabetes. As well, the plans that are covering it when prescribed for Diabetes are mostly developing pre-authorization criteria and processes to ensure that only Type 2 Diabetes is treated. Provincial drug plans also generally do not pay for coverage of this drug at this time.
• Even for Diabetics, Canadian insurers and provincial government plans require them to use the more cost-effective first-line therapy, Metformin, before ever being considered for Ozempic.
Much of the recent discussions around Ozempic, and largely the criticisms of the drug, are centered around the concept of people using a prescription drug to achieve weight loss. However, in my opinion, there are a few things that should be considered before making this determination:
• Some people may be looking at this as a “lifestyle drug” issue given that people might be using Ozempic as a shortcut for weight loss instead of first looking to diet and exercise. Part of these criticisms may be a result of obesity still not truly being recognized as a “disease” in Canada. Many would likely reconsider critiquing the use of drugs to help manage “diseases” versus being used simply for “lifestyle” purposes.
• If Ozempic does in fact help achieve weight loss, would that not mean better health in general for employees? Would it then not be worth the cost? When overall long-term health is considered, in general, individuals with excess weight often have other health-related issues (co-morbidities such as hypertension, high cholesterol, diabetes, depression, etc.). The cost savings of those individuals coming off their existing medications in the long term would most certainly outweigh the cost of Ozempic.
• If an obese individual can use Ozempic to lose weight, it could be potentially motivating for them to go further with diet and exercise. They might see some initial quick results and then get motivated to see more, and believe that long term weight loss is possible. As well, some individuals may not actually be able to start an exercise regimen without the help of some initial weight loss in order to facilitate greater mobility for exercise.
• Most organizations in Canada are currently focused on meeting the varying needs of employees through Diversity, Equity and Inclusion (“DEI”) initiatives. It might be argued that overweight employees have their own specific needs and that investments in weight loss drugs could be seen as being beneficial in the same way as many other DEI initiatives.
Ozempic has generally become a top-10 or even a top-5 prescription drug in Canada for employee benefits plans and we do not expect this to subside for quite some time. However, we need to see past the social media rhetoric and debunk the myths they are creating, and recognize that, at this time, this drug is primarily being used to treat severe cases of Diabetes, which is a good thing. More importantly, we need to recognize that Ozempic is truly a revolutionary drug for those with severe Diabetes and it could also be a revolutionary drug for weight loss. If that is the case, plan sponsors might be interested in taking a more holistic view of their employee benefits plan and incorporating the use of Ozempic or other similar drugs to help improve employee wellbeing and meet employees’ needs.
We would be pleased to discuss your specific situation with you to identify the best strategy for your employee benefits plans. Should you have any questions on the above, please do not hesitate to contact any member of our team.
ZLC Employee Benefits Solutions is one of the fastest growing advisors for employee benefits and group retirement programs in Vancouver and we are fortunate to have the best people, resources, and clients. We provide value by leveraging one of the most skilled benefits teams – collectively over 400 years of experience within our team of 20 employee benefits specialists. We have been working with businesses ranging from 3 to over 75,000 plan members for over 35 years.
