Welcome to a candid conversation with Dr. James Wantuck, chief medical officer of Accolade and PlushCare. We're diving deep into the intriguing dynamics of employer healthcare plans, specifically focusing on the adoption of GLP-1 medications.

Our recent Savanta survey has unveiled some surprising statistics. While 81% of HR decision-makers believe their employees are interested in GLP-1 medications, only 25% of employers offer coverage for these treatments. Is this due to the perceived high costs? Or is there another factor at play?

Dr. Wantuck will help us dispel myths, tackle contradictions, and shed light on the future of GLP-1 in employer healthcare plans. His insights will not only inform but also empower you to make confidently professional and persuasive decisions for your organization's healthcare solutions.

Q: Is it true that employers shy away from offering GLP-1 due to high costs?

A: Contrary to what we are hearing and reading from the media, we are seeing in our survey results that many employers plan to offer GLP-1 in their healthcare plans as early as next year. According to our research, 43% of medium and large employers plan to offer GLP-1 coverage next year, an increase of more than 70%. We also found that companies that currently offer GLP-1s will continue doing so at an astounding rate of 99%.[1] This is primarily driven by employee interest and engagement despite the perceived higher costs associated with these treatments. Importantly, the nuance in offering GLP-1s is that employers want to ensure they get into the hands of the employees that stand to benefit most and thus get the most value out of the medicines, so I expect we will see additional restrictions put in place to control coverage of these medicines, in the form of prior authorizations and other controlled access.

Q: Where are employers seeking advice on this matter?

A: Employers are turning to trusted medical sources for advice. The survey shows that doctors and other medical organizations are the most trusted sources of information. Importantly, benefit consultants and insurance companies scored near the bottom of the list for sourcing trusted information. We at Accolade offer all our clients the ability to consult with our physician leaders to help clients navigate coverage decisions.

Q: Why is the doctor-patient relationship crucial when it comes to individual weight management programs?

A: The doctor-patient relationship is central to individual weight management programs for several reasons. First, primary care physicians (PCPs) are best positioned to view the full picture of an employee’s health. They can order the necessary bloodwork and other diagnostics to determine who will benefit from GLP-1s or other weight management approaches. Through their trusted relationships with patients, they can help patients manage their obesity-related conditions such as high blood pressure and joint disease, to name a few. Lastly, a physician’s expertise is invaluable when deciding on the best course of treatment for each patient. Not every patient needs the same care, and instead of putting this decision-making power solely in the hands of pharmacy benefit managers or health plans, it should be centered around a patient’s physician, who has a comprehensive understanding of the patient's health status.

This approach ensures that the treatment plan is not only clinically effective but also personalized to the patient's needs and circumstances. It fosters an environment where patients feel listened to and cared for, thereby increasing the likelihood of successful treatment and improved quality of life.

Remember, weight management is not just about shedding weight; it's about improving overall well-being. And that's why the doctor-patient relationship is so important in this context.

Q: What does the future look like for GLP-1 in employer healthcare plans?

A: The future looks promising. Our research is strong proof that these medicines are not just continuing to gain usage, but also that those that cover them see them as beneficial to have in a plan for at least some portion of the population. As scientific evidence of their benefit mounts, it will become harder and harder to justify not covering these breakthrough medications for at least some members.

Remember, confidently choosing the right healthcare solutions for your employees is not just about cost, but also about engagement, trust, and long-term health benefits. At Accolade, we're here to help you navigate these choices with confidence and clarity.

James Wantuck, MD, associate chief medical officer, Accolade & PlushCare

As associate chief medical officer at Accolade and co-founder of PlushCare, Dr. Wantuck is responsible for leading the clinical organization at PlushCare and contributing to significant strategic initiatives at Accolade. He is focused on managing a large and growing group of physicians, therapists, nurses, and other staff with a goal of creating a high-performing clinical organization that is viewed as a premier place to work.

Dr. Wantuck is a board-certified internal medicine physician, having trained at Stanford University Medical Center and completed his Medical Doctorate at Vanderbilt University Medical School. He co-founded PlushCare in 2015, building the company from the ground up, building a group of over one hundred physicians, and caring for hundreds of thousands of patients along the way.

Accolade results are based on a Savanta survey of 500 HR decision-makers from U.S.-based medium and large businesses across a variety of industries in August and September 2023.

Source: 1. Savanta. (2023) GLP1-Employer Healthcare Thought Leadership. Internal Accolade document.