GLP-1 Drug Coverage in Canada

Published February 14, 2024

Brookfield, Wisconsin, February 9, 2024—A new survey report from the International Foundation of Employee Benefit Plans reveals results from a group of Canadian employers regarding considerations and coverage for glucagon-like peptide-1 (GLP-1) drugs, which have historically been used to treat diabetes and are increasingly being used to treat obesity.

"Coverage of GLP-1 drugs for weight loss continues to be a hot topic of discussion," said Julie Stich, CEBS, Vice President of Content at the International Foundation. "While Health Canada has not approved indication for weight loss, employers are getting requests from employees. In January 2024, the International Foundation conducted a pulse survey to find out how Canadian employers are handling this issue."

Among survey respondents, 66% provide GLP-1 drug coverage for diabetes, 17% for both diabetes and weight loss, and 1% for weight loss only. Of the respondents who only cover GLP-1 drug coverage for diabetes, 9% are considering covering GLP-1 drugs for weight loss too. This survey received responses from 82 organizations.

The most prevalent factors employers take into consideration for GLP-1 drug coverage for obesity care include:

  • Obesity as a risk factor for chronic conditions and associated costs—67%
  • Drug shortages—47%
  • Impact/effectiveness of cost-control mechanisms—47%
  • Existing coverage through government programs—40%
  • Long-term costs—33%
  • Patient and prescriber demand—33%

Organizations that are covering GLP-1 drugs are using cost-control mechanisms such as utilization management (47%), annual maximums (40%), eligibility requirements (27%) and lifetime maximums (27%).

Other diabetes or weight-loss services that are covered via the respondents' extended health plans include:

  • Other prescription/non-GLP-1 drugs—56%
  • Nutritional counseling—51%
  • Telehealth/virtual care for lifestyle interventions—30%
  • Disease management programs/case management—29%
  • Telehealth/virtual care for GLP-1 drug treatment—17%
  • Lifestyle modification programs—12%
  • Bariatric surgery—5%.

 
For more information and to view the full survey report, visit www.ifebp.org/GLP1drugsCanada.

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The International Foundation of Employee Benefit Plans is the premier educational organization dedicated to providing the diverse employee benefits community with objective, solution-oriented education, research and information to ensure the health and financial security of plan beneficiaries worldwide. The International Foundation has more than 31,000 multiemployer, corporate and public sector members representing over 25 million lives. For additional information, visit www.ifebp.org.