Blue Cross Blue Shield of Michigan will continue covering GLP-1s prescribed to treat Type 2 diabetes, including Ozempic, Rybelsus, Victoza and Mounjaro.
“The costs are a huge implication, and obviously we have to look at all drugs that we have to pay for, but we also have to look at effectiveness and we have to look at how our members are using these resources,” Grant said.
“When we got somebody a GLP-1, more than 30% of the time they actually stopped using it after the first month. So what they’re doing is, they’re actually not waiting long enough to see the positive effects of the drug.”
Annual claims for weight-loss drugs have skyrocketed from $8 million in 2021 to $100 million so far this year, Grant said. The company is on track to spend nearly $200 million by 2025, he added.
The average monthly list price for semaglutide, the clinical name for Wegovy, is over $1,000, according to a brief by Blue Health Intelligence commissioned by the Blue Cross Blue Shield Association. Similar weight-loss drugs can cost between $900 and $1,100 monthly.
Blue Cross Blue Shield of Michigan’s decision to eliminate coverage for weight-loss drugs puts the company in line with other insurers in the state that don’t cover the costs of those drugs.
