How Ozempic Off-label Use Could Impact Employers’ Checkbooks and American’s Waistlines

From SNL skits to an abundance of news headlines, everyone seems to be talking about Ozempic, but how prevalent is this buzzword drug in your population? Here’s everything employers and HR leaders need to know about diabetic medication turned cultural weight loss sensation:

What is Ozempic?

Non-insulin Ozempic® also branded as Wegovy and Rybelsus, is a subcutaneous injected medication. This Type 2 Diabetes medication responds to a rise in blood sugar levels by aiding the body in releasing its own insulin. Ozempic was approved by the FDA in 2017 for diabetes management.  

Common side effects of Ozempic include abdominal pain, constipation, diarrhea, and nausea. Although the FDA has not approved Ozempic for weight reduction, another effect research suggests modest weight loss while taking the medication.

How Does Ozempic Lead to Weight Loss?

Ozempic aids in lowering A1C, and as a semaglutide it also acts as an appetite suppressant by inducing satiety so that the body feels fuller for longer. A study has shown that those taking Ozempic had on average a 12-14 pounds reduction in weight when paired with a deficit calorie diet.  

How Much Does Ozempic Cost Employers?

For 1 MG Ozempic the PMPM Employer Paid Amount (Rx) costs were $1,199 in our book of business last year.  

Wegovy, a higher dose of the same semaglutide in Ozempic, is approved by the FDA for weight loss. Wegovy reportedly costs around $1,432 per month.  

Mounjaro is an FDA-approved diabetic medication, however, it may also be approved for weight loss sometime this year. Mounjaro is a tirzepatide that also suppresses appetite leading to even more significant weight loss compared to Ozempic in recent studies. The PMPM Employer Paid Amount (Rx) for Mounjaro last year in our database was $782.

To learn more about the differences between these medications and how their costs are impacting employers, we highly recommend Dr. Bricker’s Financial Implications of Ozempic, Wegovy and Mounjaro Training.

So Why is There So Much Hype Around Ozempic?

Increasing rates of overweight and obesity in adults in children in the United States can result in the development of costly chronic conditions such as heart and kidney disease, Type 2 Diabetes, and certain cancers.  

Maintaining a healthy weight is a key factor in mitigating the possibility of developing chronic diseases, such as Type 2 Diabetes, and is also important in the ongoing management of Type 2 Diabetes.

Our recent monthly insight focuses on obesity and claims related to prescription drugs developed to assist with weight loss. This story also looks into prescription drugs, such as Ozempic, that are increasingly being used for weight loss but are not FDA-approved for this purpose. While off-label prescribing has become more common, there can be risks associated with these medications. The influx of off-label use can also dramatically affect medication supply and demand over time, potentially making it more difficult for individuals to obtain medications needed for their intended purposes.

How Can I Weigh the Impact of Obesity, Ozempic, and Off-Label Use in My Population?

With a cultural fixation on thinness along with growing obesity rates and associated health risks, a continued increase in the demand for weight loss medications is inevitable. Recent updated FDA guidelines of weight loss drugs in children as young as 12 for pediatric obesity, along with Mounjaro being poised for FDA approval for weight loss purposes later this year, are among many factors that could continue to drive the increase in use and costs.

To explore the current and potential impact of weight loss drugs in your population, reach out to your Artemis advisor or contact us to learn how to get started with Artemis today.