Obesity medication access gaps increase health plan costs for Canadian employers

Employers can reduce costs and improve productivity by including obesity management in benefit plans

Obesity medication access gaps increase health plan costs for Canadian employers

According to Benefits and Pension Monitor, obesity increases the risk of chronic illnesses that significantly raise health benefit plan costs.  

These chronic illnesses, such as type 2 diabetes, hypertension, depression, asthma, and inflammatory conditions, are among the top drivers of health benefit expenses in Canada.  

While an increasing number of Canadians require obesity medications, a substantial portion of individuals are unable to access them, widening the gap in coverage. 

The Obesity Toolkit case study by Novo Nordisk Canada Inc. highlights that many benefit plans in Canada do not correctly classify obesity as a chronic disease, leading to limited access to appropriate care. This oversight contributes to higher absenteeism, presenteeism, and reduced productivity in the workplace.  

The need for proper obesity medication coverage is further supported by the fact that the total prescription rate for obesity medication is growing annually by more than 10 percent. 

Economic data underscores the urgency of addressing obesity in the workplace. In Canada, the economic burden of obesity reached $7.1bn in 2010, with $3.9bn attributed to direct medical costs and $3.2bn related to disability, productivity loss, and early death.  

Furthermore, reducing an individual’s weight by 13 percent can lower the risk of developing type 2 diabetes by 41 percent. Despite these statistics, Canadians with private drug insurance often lack access to obesity medication through their benefit plans. 

The case study provides insights into how employers and benefit advisors can address this issue. They can start by incorporating best practices on obesity coverage that align with the Canadian Adult Obesity Clinical Practice Guidelines.  

Employers should also recognize the importance of health benefit plans covering obesity medication, which can help manage the impact of chronic illnesses linked to obesity. Moreover, benefit advisors can play a key role in ensuring obesity management is included in benefit plans. 

To reduce the economic burden of obesity and improve workplace productivity, providing coverage for obesity medications is vital.  

According to data from the case study, the cost of covering obesity medication is less than $10 per covered life annually, which pales in comparison to the expenses incurred from obesity-related illnesses. In 2022, the average monthly cost of obesity medication per 1,000 covered lives stood at $786. 

Obesity poses a significant challenge to Canadian workplaces, and effective management through comprehensive benefit plans can make a difference.  

Ensuring access to evidence-based treatments and support, as highlighted in the case study, can help employers enhance employee well-being and mitigate rising health costs