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Vt. (WCAX) – The UVM Health Network is dropping insurance coverage for GLP-1 weight-loss drugs, a move that could affect hundreds of employees and save the cash-strapped health network nearly $19 million
“I was a skeptic, and I didn’t necessarily jump right on board,” said Mike Popovitch, an operating room radiology technologist at UVM Medical Center. “Periods of time where I wasn’t eating meals, and I still wasn’t losing weight.”
After trying everything to lose weight, Popovitch turned to GLP-1 medications. He’s now been on them and seeing success for 18 months. “I said I’d give it a shot, and immediate results. I lost 35 pounds in three weeks,” Popovitch said
Initially, his prescription was partially paid for by his insurance through UVM Health. But earlier this month, the health network announced it would no longer cover the use of GLP-1 drugs for weight loss
“I was devastated, you know, without trying to be cheesy or anything, it really, it really was just devastating,” Popovitch said
It comes as UVM Health Network scrambles to cut costs in the face of a $300 million budget deficit over the next three years. A spokesperson told WCAX the change is expected to save UVM Health about $19 million, based on the current monthly cost of covering the drugs for the number of employees using them for weight loss
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It’s not just in Vermont. Employers across the country, facing rising health care costs themselves, are cutting coverage of these weight-loss drugs, according to Matthew Rae, a health care marketplace researcher with the Kaiser Family Foundation. He has been tracking the trend. “Employers offered it, they were blown away by how much money they were spending. Many employers saying they were spending much more than they anticipated, and now there’s sort of a little bit of a retreat with fewer employers offering GLP-1 coverage,” Rae said.
But will this save employers money in the long run orr is it just a short-term solution? Rae says it’s too soon to know. “I think the evidence is still mixed. We’re still learning. There’s still lots of research to be done. I think right now the consensus is that these drugs don’t reduce cost on the overall plan in the sort of short to medium term,” he said
UVM Health says it weighed potential long-term savings against drug costs, but decided the change was necessary to protect premiums and the plan’s sustainability
Employees like Popovitch are already seeing the impacts. Though the coverage change does not start until Sept. 1, he says his insurance denied pre-authorization for his next dose. He ran out of his medication Wednesday, and now he has to decide whether to pay out-of-pocket for a drug he says has helped him both physically and mentally. “I can’t press how much the drug has done for not just my health but for the self-image and confidence and anxiety,” Popovitch said
UVM Health says the change only affects GLP-1 coverage specifically for weight loss. Coverage continues for diabetes management and other health conditions. Employees still have access to non-GLP-1 weight-loss re
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