Employers should consider raising the stakes on combating employee obesity by incorporating more incentives for weight-loss medications.
That message was delivered by James Tacci, M.D., Xerox Corp. global corporate medical director, at a Dallas-Fort Worth Business Group on Health luncheon in north Dallas last week.
Tacci said corporate executives tend to talk more about diagnoses—such as diabetes, cancer, and heart disease—than obesity. However, the prevalence of those conditions rises in direct proportion to a workforce’s obesity rate.
Tacci also said there is a linear association between obesity and a company’s healthcare costs. He said workers compensation costs are twice as high for obese employees, compared with those of normal weight.
The annual costs for an employee with a body mass index of 27—or a 178-pound man who is 5’8″—and high blood pressure or cholesterol is $15,000, and $20,000 for an overweight employee with diabetes. The average per-capita employee healthcare costs are $10,000.
Tacci said he recently spoke to a utility company executive who said he had to redo a fleet of cherry-picker forklifts because too many employees were exceeding the 250-pound basket weight limit.
The most common obesity management tactics used by companies, Tacci said, are changing the work environment to support healthy behavior, wellness programs, and offering weight-loss programs at the worksite.
According to a survey by the consultant The Benfield Group, about 3 out of 4 benefits managers said their tactics were “somewhat” effective. However, 97 percent agreed with the statement: “The trend among our employee population is toward increasing levels of obesity.”
Tacci said recent studies on workplace weight-loss programs are mixed, with most reporting modest results, none that show long-term follow-up, and only about half were effective.
Tacci encouraged employers to cover obesity medications as comprehensively as they do smoking-cessation drugs.
The obesity drug Belviq is being launched next month. Qsymia is already on the market. Both received Food and Drug Administration approval last year. The drugs are intended for those with a BMI of 30 or more, and for those with a BMI of 27 and at least one-weight-related condition.
In trials, about half of those taking Belviq for 1-2 years lost at least 5 percent of their body weight, compared with about 70 percent of those taking Qsymia. (The clinical trials had different designs so they should not be interpreted as a comparison.)
Tacci said there are three levels of employer support for weight management medication. Basic coverage simply would allow employee access. Intermediate incentives would encourage appropriate medication use in exchange for an accountability measure. The highest level of support would be a value-based benefit design that minimizes out-of-pocket costs for those who also pursue behavioral programs and achieve their weight-loss goals.
Steve Jacob is editor of D Healthcare Daily and author of the book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at [email protected]