From a Chief Medical Officer: What Employers Should Know about GLP-1 medications

Controlling healthcare spending relies on more than medication management and coaching: organizations need a way to address the complex, interconnected nature of obesity and overall health. Chief Medical Officer of Hello Alpha, Dr. Mary Jacobson, drills down into the company’s approach to Ahead with AlphaTM, their new weight management program for employers, and how to get patients the level and quality of care they need while respecting employers’ healthcare budgets.

It seems every website, magazine, and media outlet is publishing article after article about new weight loss drugs like Ozempic and Mounjaro, so it’s no surprise that this is top of mind for employers and health plans. It seems we might be in a classic “rock and a hard place” situation: the rock is the undeniable need for effective obesity treatment, and the hard place is a business’s need to contain costs. But perhaps the situation is not quite so binary.

Weight management and metabolic health are important for individual health and have a significant financial impact on employers, who bear many of the costs related to obesity. The Centers for Disease Control (CDC) estimates the annual medical cost of obesity in the U.S. was $173 billion in 2019. Almost half of working-age Americans have obesity and their annual medical costs are on average 50% higher, driving up health plan costs. Medical costs for adults with obesity are $1,861 higher than for adults at a healthy weight. Employers can see reduced healthcare spend through the downstream health benefits of weight loss, yet traditional health plans and providers treat obesity as a willpower issue and not as a complex, chronic condition. Employers also face indirect costs related to obesity, such as productivity losses, sick days, short-term disability, and workers’ compensation claims. For those with obesity, losing 5–10% of body weight can improve their health in a myriad of ways, from decreasing joint pain to lowering blood sugar, blood pressure, and triglyceride levels.

The shift away from characterizing obesity as a personal failing to a chronic medical condition is a promising sign of progress. However, the fixation on GLP-1s as a magic bullet also misses the complex nature of obesity, especially for sustained weight loss and overall health. The Obesity Medicine Association defines obesity as “a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.” Effective, lasting treatment for obesity must focus on more than just medication. A siloed approach to weight management also means that a patient is less likely to be screened for a chronic condition, which further drives up healthcare costs for individuals and employers.

As a trained OB/GYN and Chief Medical Officer, I have watched the growth in employer weight management programs with keen interest as our clinical team at Hello Alpha successfully treated thousands of consumer patients for sustained weight loss. Knowing that an estimated 22% of employer-sponsored health plans cover prescription weight loss medication, while 45% cover bariatric surgery, I can see that businesses have significant and justified trepidation around covering these new drugs.

With that background, we designed the clinical protocols and launched Ahead with Alpha™, which combines the cost-saving benefits of primary care with new breakthroughs in metabolic health, to have three specific components:

1. Real-world outcomes data. Hello Alpha has treated over 50,000 consumer patients with excess weight and, through that experience, we developed expertise in prior authorization, step therapy, and formulary management. Our patients being treated for obesity experience a sustained 15% reduction in BMI after 10+ months. With the quickly evolving landscape around weight management, this real-world data is vital. But we can’t forget that ultimately it comes back to taking care of patients. We build relationships with our patients, instead of a series of transactions, by connecting them to a dedicated provider for their overall mental and physical health. Our team gets amazing, heartwarming stories from patients who are getting a high level of care they never received before. Within six months, 20% of weight loss patients returned to their Alpha provider for treatment of another medical condition.
2. An integrated approach with comorbidities. Traditional point solutions disconnect obesity from chronic conditions, driving up healthcare spend without any cost containment. This fragmentation means employers are missing out on cost savings. Obesity is ideally treated by a dedicated primary care provider alongside diabetes, PCOS, joint pain, heart disease, and more. Additionally, prescribing GLP-1 medications requires focused attention on a patient’s mental health, particularly given recent concerns from EU regulators about depression and suicidal ideation that may accompany this class of drug. Issues like binge-eating disorder and anxiety must also be treated — whether they’re caused by the social stigma of obesity or contributing to a patient’s weight gain.
3. Step therapy and/or a maintenance plan. This comes back to cost containment: a successful program must take into account the significant price tags of GLP-1s. There are traditional weight loss tactics readily available such as visits with registered dietitians, behavioral coaching, counseling about exercise, stress management, and more. There are lower cost medications that can be leveraged. And, when appropriate, GLP-1s should also be prescribed. Once a patient has successfully lost weight, they must be carefully migrated into a lower cost maintenance program to sustain results for the patient and to smartly use employer resources.

Obesity is expensive. It has a high propensity of comorbidities, and to truly contain cost, multi-chronic patients need to be treated holistically. Whole-person primary care is the answer; it generates proven savings, and Hello Alpha has demonstrated expertise in getting patients to engage holistically with that type of care. It’s in our DNA. Weight management is changing so quickly–employers want a sustainable solution built on a reliable foundation.

About Hello Alpha

Hello Alpha is a virtual primary care platform that specializes in inclusive, expert care for all by bridging the gaps in women’s health. Through technology and a specially-trained team of primary care providers (PCPs), Hello Alpha delivers whole-person care and expands healthcare accessibility. Hello Alpha’s approach to weight management balances lifestyle changes with new medication to deliver strong, sustained clinical outcomes in a cost-effective manner. Every patient partners with a dedicated PCP who provides personalized, preventive care and evidence-based treatment at every visit. Our platform eliminates the most common barriers to healthcare with asynchronous telehealth visits that empower patients to get care at any time without appointments, travel, or waiting rooms. Founded in 2017, Hello Alpha provides patient care nationwide at a demonstrably lower cost. Hello Alpha serves patients directly and through their employers.